Internal Medicine In North Miami Beach Florida

NPI list of 103 internal medicine registered providers with a business address in North Miami Beach, FL of which 45 are registered as organizations and 58 as individuals. A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

NPI Name Type Taxonomy Address Medicare PECOS
1003004276VINCENZO NOVARA MD PAOrganizationInternal Medicine
(Pulmonary Disease)
100 NW 170TH ST SUITE 301
NORTH MIAMI BEACH, FL 33169
(305) 651-3033
Non-Participating ProviderNO
1003061631MORTON JOSEPH SANETIndividualInternal Medicine
(Cardiovascular Disease)
1150 NE 170TH STREET
NORTH MIAMI BEACH, FL 33162
(305) 651-6580
Non-Participating ProviderNO
1003899212JOSE A LAVERGNEIndividualInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE #202
NORTH MIAMI BEACH, FL 33162
(305) 770-0062
Accepts MedicareYES
1023091246THE GI GROUP OF SOUTH FLORIDA PA
ORNSTEIN ROMAN & NEUSTATER MD PA
OrganizationInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE SUITE 202
NORTH MIAMI BEACH, FL 33162
(305) 770-0062
Non-Participating ProviderNO
1013199595MARWAN ISKANDARANI MD PAOrganizationInternal Medicine
(Gastroenterology)
65 NW 168TH ST
NORTH MIAMI BEACH, FL 33169
(305) 653-6365
Non-Participating ProviderNO
1013067289ANDY ARWARIIndividualInternal Medicine
(Hospice and Palliative Medicine)
16800 NW 2ND AVE STE 400
NORTH MIAMI BEACH, FL 33169
(786) 620-8289
Non-Participating ProviderYES
1033171517VICTOR I TAMAYOIndividualInternal Medicine301 NE 167TH ST
NORTH MIAMI BEACH, FL 33162
(305) 940-0522
Accepts MedicareYES
1053320861MARTA LUCIA CUELLARIndividualInternal Medicine
(Rheumatology)
100 NW 170TH ST SUITE # 410
NORTH MIAMI BEACH, FL 33169
(305) 654-6850
Non-Participating ProviderYES
1093964538SALAH AMER MD PAOrganizationInternal Medicine
(Cardiovascular Disease)
1380 NE MIAMI GARDENS DR SUITE 140
NORTH MIAMI BEACH, FL 33179
(305) 948-3990
Non-Participating ProviderNO
1043411150REYAN AZAD GHANYIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33161
(305) 949-0999
Non-Participating ProviderYES
1073571071MOSKOWITZ AND COHEN PAOrganizationInternal Medicine
(Gastroenterology)
909 NORTH MIAMI BEACH BLVD #302
NORTH MIAMI BEACH, FL 33162
(305) 949-2491
Non-Participating ProviderNO
1033316963SUPREME MEDICAL CARE INCOrganizationInternal Medicine1380 NE MIAMI GARDENS DR SUITE 138
NORTH MIAMI BEACH, FL 33179
(305) 948-8900
Non-Participating ProviderNO
1033527098SHAMFA JOSEPHIndividualInternal Medicine100 NW 170TH ST STE 410
NORTH MIAMI BEACH, FL 33169
(305) 654-6850
Accepts MedicareYES
1033788443ALEXANDER MEDICAL SPA, PAOrganizationInternal Medicine3363 NE 163RD ST STE 505
NORTH MIAMI BEACH, FL 33160
(786) 801-3122
Non-Participating ProviderNO
1245212000BRETT R NEUSTATERIndividualInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE #202
NORTH MIAMI BEACH, FL 33162
(305) 770-0062
Accepts MedicareYES
1245213453LEWIS R FELDERIndividualInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE #202
NORTH MIAMI BEACH, FL 33162
(305) 770-0062
Accepts MedicareYES
1124001334RICARDO J ROMANIndividualInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE SUITE 202
NORTH MIAMI BEACH, FL 33162
(305) 770-0062
Accepts MedicareYES
1104880533RAYMOND B SANDLERIndividualInternal Medicine
(Gastroenterology)
100 NW 170TH ST SUITE 410
NORTH MIAMI BEACH, FL 33169
(305) 654-6850
Accepts MedicareYES
1235182494CARLOS F CORRALESIndividualInternal Medicine
(Pulmonary Disease)
16855 NE 2ND AVE SUITE 302 A
NORTH MIAMI BEACH, FL 33162
(305) 653-8566
Non-Participating ProviderNO
1184655466NUZHAT A ABBASIIndividualInternal Medicine16401 NW 2ND AVE #200
NORTH MIAMI BEACH, FL 33169
(305) 947-7196
Accepts MedicareYES
1225231004EILEEN M RAMSARAN M.D., P.A.OrganizationInternal Medicine13899 BISCAYNE BLVD SUITE 132
NORTH MIAMI BEACH, FL 33181
(305) 681-1050
Non-Participating ProviderNO
1225207319CARLOS F. CORRALES, D.O., P.A.OrganizationInternal Medicine
(Pulmonary Disease)
16855 NE 2ND AVE SUITE 302A
NORTH MIAMI BEACH, FL 33162
(305) 653-8566
Non-Participating ProviderNO
1225377385ANTHONY J PANARIELLO MD PAOrganizationInternal Medicine
(Pulmonary Disease)
1380 NE MIAMI GARDENS DR SUITE 140
NORTH MIAMI BEACH, FL 33179
(305) 948-8900
Non-Participating ProviderNO
1184034241EPIC MEDICAL CENTERSOrganizationInternal Medicine1 NE 167TH ST
NORTH MIAMI BEACH, FL 33162
(786) 317-2377
Non-Participating ProviderNO
1194109447BUENA AVENTURA MEDICAL GROUP, LLCOrganizationInternal Medicine
(Cardiovascular Disease)
20818 W. DIXIE HWY
NORTH MIAMI BEACH, FL 33180
(786) 520-3382
Non-Participating ProviderNO
1154308450NEIL FURMANIndividualInternal Medicine1380 NE MIAMI GARDENS DRIVE SUITE 225
NORTH MIAMI BEACH, FL 33179
(305) 651-6891
Accepts MedicareYES
1164780326ILEANA FARRADAIndividualInternal Medicine
(Nephrology)
16401 NW 2ND AVE STE 203
NORTH MIAMI BEACH, FL 33169
(305) 999-0009
Accepts MedicareYES
1154700151MELISSA CHAMBLAINIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Non-Participating ProviderYES
1194764217MARCUS G SANTANAIndividualInternal Medicine
(Pulmonary Disease)
100 NW 170TH ST STE 301
NORTH MIAMI BEACH, FL 33169
(305) 651-3038
Accepts MedicareYES
1104424027NEIGHBORMD OF NORTH MIAMI BEACH LLCOrganizationInternal Medicine150 NW 168TH ST STE 301
NORTH MIAMI BEACH, FL 33169
(305) 654-5440
Non-Participating ProviderNO
1558322289ANITA L PETTEWAY MD PAOrganizationInternal Medicine909 N MIAMI BEACH BLVD SUITE 503
NORTH MIAMI BEACH, FL 33162
(305) 944-8887
Non-Participating ProviderNO
1295788008JACK ROBERT COHENIndividualInternal Medicine909 N MIAMI BEACH BLVD SUITE 302
NORTH MIAMI BEACH, FL 33162
(305) 949-2491
Non-Participating ProviderYES
1346289691ANTHONY JOSEPH PANARIELLOIndividualInternal Medicine
(Pulmonary Disease)
1380 NE MIAMI GARDENS DR SUITE 138
NORTH MIAMI BEACH, FL 33179
(305) 652-6501
Accepts MedicareYES
1518989581VINCENZO NOVARAIndividualInternal Medicine
(Pulmonary Disease)
100 NW 170TH ST SUITE 102
NORTH MIAMI BEACH, FL 33169
(305) 654-6890
Accepts MedicareYES
1457466732HENRY NG CHUAIndividualInternal Medicine
(Cardiovascular Disease)
100 NW 170TH ST STE 411
NORTH MIAMI BEACH, FL 33169
(305) 249-5666
Non-Participating ProviderYES
1295889848ASSAF TZURIndividualInternal Medicine
(Clinical Cardiac Electrophysiology)
100 NW 170TH ST SUITE 401
NORTH MIAMI BEACH, FL 33169
(305) 655-1877
Accepts MedicareYES
1487868410CARDIOLOGY ASSOCIATES OF NORTH MIAMI BEACH PAOrganizationInternal Medicine
(Cardiovascular Disease)
18260 NE 19TH AVE SUITE 201
NORTH MIAMI BEACH, FL 33162
(305) 956-9062
Non-Participating ProviderNO
1427264258WILLIAM BERKEIndividualInternal Medicine
(Hospice and Palliative Medicine)
1400 NE MIAMI GARDENS DR SUITE 202
NORTH MIAMI BEACH, FL 33179
(305) 940-7546
Non-Participating ProviderNO
1316190283HEMATO-ONOCOLOGY MEDICINE ASSOCIATES PAOrganizationInternal Medicine
(Hematology & Oncology)
16948 NE 19TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 949-4259
Non-Participating ProviderNO
1386953750CENTER FOR ENDOCRINE DISEASES AND ENDOCRINE TUMOROrganizationInternal Medicine
(Endocrinology, Diabetes & Metabolism)
100 NW 170TH ST SUITE 101
NORTH MIAMI BEACH, FL 33169
(786) 261-0222
Non-Participating ProviderNO
1518239938KAPLAN, REICH & ZUCKER, M.D.'S P.A.OrganizationInternal Medicine16800 NW 2ND AVE #306
NORTH MIAMI BEACH, FL 33169
(305) 652-9652
Non-Participating ProviderNO
1396847240HOWARD B REINFELD AND ASSOC MD PAOrganizationInternal Medicine
(Cardiovascular Disease)
18260 NE 19TH AVE SUITE 201
NORTH MIAMI BEACH, FL 33162
(305) 956-9062
Non-Participating ProviderNO
1427002393RONALD S LUBETSKYIndividualInternal Medicine1380 NE MIAMI GARDENS DR SUITE 280
NORTH MIAMI BEACH, FL 33179
(786) 274-8080
Accepts MedicareYES
1447382742PROCARE HEALTH CENTER INCOrganizationInternal Medicine1380 NE MIAMI GARDENS DR SUITE 280
NORTH MIAMI BEACH, FL 33179
(786) 274-8080
Non-Participating ProviderNO
1407045644ANITA PETTEWAYIndividualInternal Medicine909 N MIAMI BEACH BLVD SUITE 503
NORTH MIAMI BEACH, FL 33162
(305) 944-8887
Accepts MedicareYES
1477957967EXELSIOR MEDICAL GROUP, INC.OrganizationInternal Medicine951 NE 167TH ST SUITE 102
NORTH MIAMI BEACH, FL 33162
(305) 944-1122
Non-Participating ProviderNO
1386607836WADDAH ALLAFIndividualInternal Medicine
(Pulmonary Disease)
18100 NE 19TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 949-6003
Accepts MedicareYES
1497704712JEROME S REICHIndividualInternal Medicine1380 NE MIAMI GARDENS DRIVE #225
NORTH MIAMI BEACH, FL 33179
(305) 652-9652
Non-Participating ProviderNO
1255386470MARWAN ISKANDARANIIndividualInternal Medicine
(Gastroenterology)
65 NW 168TH ST
NORTH MIAMI BEACH, FL 33169
(305) 653-9174
Accepts MedicareYES
1487005195MIAMI RENAL INSTITUTE LLCOrganizationInternal Medicine
(Nephrology)
2040 NE 163RD ST STE 204
NORTH MIAMI BEACH, FL 33162
Non-Participating ProviderNO
1407879752SHELDON STALLERIndividualInternal Medicine150 NW 168TH ST STE 301
NORTH MIAMI BEACH, FL 33169
(305) 654-5440
Non-Participating ProviderYES
1346716545A RESCUE HEALTH CARE INCOrganizationInternal Medicine1869 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(786) 553-8422
Non-Participating ProviderNO
1437136744HANDRE HURWITIndividualInternal Medicine
(Cardiovascular Disease)
100 NW 170TH ST STE 101
NORTH MIAMI BEACH, FL 33169
(786) 785-0585
Non-Participating ProviderNO
1538572953ROCHELLE F MARILLIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Non-Participating ProviderYES
1326070319HOWARD B REINFELDIndividualInternal Medicine
(Cardiovascular Disease)
18260 NE 19TH AVE SUITE 201
NORTH MIAMI BEACH, FL 33162
(305) 956-9062
Accepts MedicareYES
1578805867MARISELA RIVES-SANCHEZIndividualInternal Medicine
(Pulmonary Disease)
100 NW 170TH ST STE 301
NORTH MIAMI BEACH, FL 33169
(305) 651-3038
Accepts MedicareYES
1275588204HEMORRHOID CENTER OF SOUTH FLORIDA
COASTAL SOUTH MEDICAL
OrganizationInternal Medicine
(Gastroenterology)
16800 NW 2ND AVE SUITE 606
NORTH MIAMI BEACH, FL 33169
(305) 492-2226
Non-Participating ProviderNO
1265639298MEDCHOICE HEATLH CENTERS, INC.OrganizationInternal Medicine16260 NE 13TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 944-1122
Non-Participating ProviderNO
1407823925LUIS F DE JONGHIndividualInternal Medicine1648 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(305) 651-3543
Accepts MedicareYES
1518926864YVANA PATRICIA CESPEDESIndividualInternal Medicine17101 NE 19TH AVE STE 101
NORTH MIAMI BEACH, FL 33162
(305) 940-7766
Accepts MedicareYES
1528633757CONVIVA MEDICAL CENTER MANAGEMENT LLCOrganizationInternal Medicine1648 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(305) 949-2000
Non-Participating ProviderNO
1518228121OVIDIU GHITAIndividualInternal Medicine1380 NE MIAMI GARDENS DR STE 100
NORTH MIAMI BEACH, FL 33179
(305) 940-6973
Accepts MedicareYES
1639132897CLIFF GLASSERIndividualInternal Medicine
(Nephrology)
16401 NW 2ND AVE SUITE 203
NORTH MIAMI BEACH, FL 33169
(305) 999-0009
Accepts MedicareYES
1730132564JEROME MOSKOWITZIndividualInternal Medicine909 N MIAMI BEACH BLVD SUITE 302
NORTH MIAMI BEACH, FL 33162
(305) 949-2491
Non-Participating ProviderYES
1730113572STEPHEN A KOTZENIndividualInternal Medicine
(Infectious Disease)
100 NW 170TH ST STE 405
NORTH MIAMI BEACH, FL 33169
(305) 653-5456
Non-Participating ProviderNO
1639191786DON POSTERIndividualInternal Medicine
(Hematology & Oncology)
16948 NE 19TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 949-4259
Accepts MedicareYES
1942313291MARC S CARPIndividualInternal Medicine
(Gastroenterology)
1400 NE MIAMI GARDENS DR SUITE 221
NORTH MIAMI BEACH, FL 33179
(305) 949-2020
Accepts MedicareYES
1972673242HENRY NG CHUA MD PAOrganizationInternal Medicine
(Cardiovascular Disease)
100 NW 170TH ST STE 411
NORTH MIAMI BEACH, FL 33169
(305) 249-5666
Non-Participating ProviderNO
1881732634NOVA SOUTHEASTERN UNIVERSITY, INCOrganizationInternal Medicine1750 NE 167TH STREET
NORTH MIAMI BEACH, FL 33162
(954) 262-4100
Non-Participating ProviderNO
1659592319INTERNAL MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.OrganizationInternal Medicine1380 NE MIAMI GARDENS DR STE 100
NORTH MIAMI BEACH, FL 33179
(305) 940-6973
Non-Participating ProviderNO
1821291188INTERNAL MEDICINE, PRIMARY CARE ASSOCIATES OF SOUTH FLORIDA, P.A.OrganizationInternal Medicine301 NE 167TH ST
NORTH MIAMI BEACH, FL 33162
(305) 940-0522
Non-Participating ProviderNO
1871780643MEDCHOICE MEDICAL CENTEROrganizationInternal Medicine16260 NE 13TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 944-1122
Non-Participating ProviderNO
1962683136STEPHEN A KOTZEN MD PAOrganizationInternal Medicine
(Infectious Disease)
100 NW 170TH ST SUITE 405
NORTH MIAMI BEACH, FL 33169
(305) 653-5456
Non-Participating ProviderNO
1891964219HOWARD F SUSSMAN DBA NEW PARKWAY EKG READERS INCOrganizationInternal Medicine
(Clinical Cardiac Electrophysiology)
100 NW 170 STREET SUITE 405
NORTH MIAMI BEACH, FL 33169
(305) 654-5440
Non-Participating ProviderNO
1801052212NEIL FURMAN DO PAOrganizationInternal Medicine
(Cardiovascular Disease)
16800 NW 2ND AVE SUITE 306
NORTH MIAMI BEACH, FL 33169
(305) 651-6891
Non-Participating ProviderNO
1841526563LEUNG HEALTHCARE NORTH MIAMI BEACH INCOrganizationInternal Medicine16260 NE 13TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 899-1406
Non-Participating ProviderNO
1629059993LARRY KATZIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Non-Participating ProviderYES
1629486386POLINA R NOSEL M.D., P.A.OrganizationInternal Medicine1380 NE MIAMI GARDENS DR
NORTH MIAMI BEACH, FL 33179
(305) 945-8111
Non-Participating ProviderNO
1699179176EXELSIOR DIAGNOSTIC SERVICE, INC.OrganizationInternal Medicine951 NE 167TH ST SUITE 102
NORTH MIAMI BEACH, FL 33162
(305) 944-1122
Non-Participating ProviderNO
1982012787FARAH MEDICAL, LLCOrganizationInternal Medicine
(Endocrinology, Diabetes & Metabolism)
1400 NE MIAMI GARDENS DR SUITE104
NORTH MIAMI BEACH, FL 33179
(305) 974-5933
Non-Participating ProviderNO
1790871481DEBORAH LYNN HOLMESIndividualInternal Medicine100 NW 170TH STREET SUITE 208
NORTH MIAMI BEACH, FL 33169
(305) 405-0045
Accepts MedicareYES
1780933820PREFERRED FAMILY CARE, INCOrganizationInternal Medicine16853 NE 2ND AVE STE 101
NORTH MIAMI BEACH, FL 33162
(305) 548-8530
Non-Participating ProviderNO
1679614655ALI NAYERIndividualInternal Medicine
(Nephrology)
2040 NE 163RD ST SUITE 204
NORTH MIAMI BEACH, FL 33162
(305) 615-1514
Accepts MedicareYES
1851343578CARLOS R SANTOSIndividualInternal Medicine
(Pulmonary Disease)
16855 NE 2ND AVE SUITE 302 A
NORTH MIAMI BEACH, FL 33162
(305) 653-0425
Accepts MedicareYES
1760844997DOLORES PRUDENTIndividualInternal Medicine1684 NE MIAMI GARDENS DR
NORTH MIAMI BEACH, FL 33179
(305) 919-1970
Accepts MedicareYES
1962504795MANUEL A GARCIA HERRANIndividualInternal Medicine1850 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(305) 882-9323
Non-Participating ProviderYES
1720510803MARLY BELINDA RODRIGUEZIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Non-Participating ProviderYES
1841588837ADAM MAXWELL AUIndividualInternal Medicine2040 NE 163RD ST STE 204
NORTH MIAMI BEACH, FL 33162
(305) 720-4004
Accepts MedicareYES
1629636584NEXUS MEDICAL CENTER OF NORTH MIAMI BEACH, LLCOrganizationInternal Medicine16751 NE 6TH AVE
NORTH MIAMI BEACH, FL 33162
(305) 750-1158
Non-Participating ProviderNO
1629065941METROPOLITAN HEALTH NETWORKS LT BLUE ZONE
METCARE
OrganizationInternal Medicine18300 NE 19TH AVE
NORTH MIAMI BEACH, FL 33179
(305) 949-7273
Non-Participating ProviderNO
1609833417WOHLFEILER PIPERATO AND ASSOCIATES, LLCOrganizationInternal Medicine16401 NW 2ND AVE SUITE 202
NORTH MIAMI BEACH, FL 33169
(305) 944-2884
Non-Participating ProviderNO
1700990553MOUNIR ANTOINE HAGEIndividualInternal Medicine1648 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(305) 949-2000
Accepts MedicareYES
1972671519VIVIAN SANCHEZIndividualInternal Medicine1648 NE 163RD ST
NORTH MIAMI BEACH, FL 33162
(305) 562-0891
Accepts MedicareYES
1902070907TRECIA ELAINE ELIZABETH MCFARLANEIndividualInternal Medicine743 NE 167TH ST
NORTH MIAMI BEACH, FL 33162
(305) 957-0017
Accepts MedicareYES
1629429808MARCOS LIMA LOPEZIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Non-Participating ProviderYES
1669611711VOLRICK DARRELL MORRISONIndividualInternal Medicine1380 NE MIAMI GARDENS DR STE 210
NORTH MIAMI BEACH, FL 33179
(305) 931-7424
Accepts MedicareYES
1669609772SATCHA BORGELLAIndividualInternal Medicine100 NW 170TH ST
NORTH MIAMI BEACH, FL 33169
(305) 654-6750
Accepts MedicareYES
1780253831JAMES YVAN BENSON RINCHEREIndividualInternal Medicine16853 NE 2ND AVE STE 101
NORTH MIAMI BEACH, FL 33162
(305) 548-8530
Non-Participating ProviderNO
1770156838ATLANTIC HEALTH MEDICAL, INCOrganizationInternal Medicine1380 NE MIAMI GARDENS DR STE 210
NORTH MIAMI BEACH, FL 33179
(305) 931-7424
Non-Participating ProviderNO
1649279761ONEIL JOSEPH PYKEIndividualInternal Medicine160 NW 170TH ST
NORTH MIAMI BEACH, FL 33169
(305) 654-5050
Non-Participating ProviderYES
1689733693SUSSMAN & STALLER MD PA
HYGEA SOUTH FLORIDA, INC
OrganizationInternal Medicine150 NW 168TH ST STE 301
NORTH MIAMI BEACH, FL 33169
(305) 654-5440
Non-Participating ProviderNO
1578810743VENTURE GASTROENTEROLOGY LLCOrganizationInternal Medicine
(Gastroenterology)
16855 NE 2ND AVE SUITE 300
NORTH MIAMI BEACH, FL 33162
(305) 654-4488
Non-Participating ProviderNO
1700307766VINAYASREE SHYAMIndividualInternal Medicine1431 NE 162ND ST
NORTH MIAMI BEACH, FL 33162
(305) 949-0999
Accepts MedicareYES

Medicare Participation

  • Participating providers are registered with Medicare and accept claims assignment. Taking claims assignment means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or co-payment amount for a visit or service.
  • Non-Participating providers do not agree to take Medicare claims assignment. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
  • Opt-out providers signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so.

What is PECOS?

PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals eligible to order or refer healthcare services for Medicare patients.