National Provider Identifier [NPI]: |
1760582779 |
Last Name Of The Provider |
HESHMATI |
First Name Of The Provider |
NIMA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
15 E HIBISCUS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
329013101 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
1410 |
Number Of Medicare Beneficiaries |
501 |
Total Submitted Charge Amount |
481360.76 |
Total Medicare Allowed Amount |
124452.24 |
Total Medicare Payment Amount |
96770.6 |
Total Medicare Standardized Payment Amount |
95980.13 |
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 |
12 |
Number Of Medical Services |
1410 |
Number Of Medicare Beneficiaries With Medical Services |
501 |
Total Medical Submitted Charge Amount |
481360.76 |
Total Medical Medicare Allowed Amount |
124452.24 |
Total Medical Medicare Payment Amount |
96770.6 |
Total Medical Medicare Standardized Payment Amount |
95980.13 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
278 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
68 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
335 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
166 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.5522 |