National Provider Identifier [NPI]: |
1144327891 |
Last Name Of The Provider |
SHAH |
First Name Of The Provider |
MONIKA |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
506 MALCOLM X BLVD |
Street Address 2 Of The Provider |
MLK 3101-A |
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100371802 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
251 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
100885 |
Total Medicare Allowed Amount |
28354.73 |
Total Medicare Payment Amount |
21995.88 |
Total Medicare Standardized Payment Amount |
19877.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
11 |
Number Of Medical Services |
251 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
100885 |
Total Medical Medicare Allowed Amount |
28354.73 |
Total Medical Medicare Payment Amount |
21995.88 |
Total Medical Medicare Standardized Payment Amount |
19877.45 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
47 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
79 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
84 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
38 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.8273 |