DR. RHEA BETTINA SANCASSANI M.D.
NPI 1003017112
Internal Medicine - Cardiovascular Disease in Miami, FL


Quality Rating: 92.02 out of 100 score

NPI Status: Active since May 29, 2007

Contact Information

1801 NW 9TH AVE STE 209
MIAMI, FL
ZIP 33136
Phone: (786) 466-8490
Fax: (305) 573-6562

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  • Individual
  • Female
  • Years of Experience 18
  • Internal Medicine
  • Cardiovascular Disease
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About RHEA SANCASSANI

Rhea Sancassani is an internist established in Miami, Florida and her medical specialization is Internal Medicine with a focus in cardiovascular disease with more than 18 years of experience. She graduated from University Of Miami, Lm Miller School Of Medicine in 2006. The healthcare provider is registered in the NPI registry with number 1003017112 assigned on May 2007. The practitioner's primary taxonomy code is 207RC0000X with license number ME104462 (FL). The provider is registered as an individual and her NPI record was last updated 7 years ago.

NPI
1003017112
Provider Name
DR. RHEA BETTINA SANCASSANI M.D.
Gender
Female
Entity Type
Individual
Location Address
1801 NW 9TH AVE STE 209 MIAMI, FL 33136
Location Phone
(786) 466-8490
Location Fax
(305) 573-6562
Mailing Address
1801 NW 9TH AVE STE 209 MIAMI, FL 33136
Mailing Phone
(786) 466-8490
Mailing Fax
(305) 573-6562
Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduation Year
2006
Is Sole Proprietor?
No
Enumeration Date
05-29-2007
Last Update Date
04-07-2017
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An internist like Rhea Sancassani is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Rhea Sancassani is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.02, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.92 for a new patient copayment and $28.1 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
License No.
ME104462
License State
FL
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Ambetter from Arizona Complete Health

    • Standard Expanded Bronze SELECT - HMO
    • Standard Gold SELECT - HMO
    • Standard Silver SELECT - HMO
  • Ambetter from Peach State Health Plan

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Bronze - HMO
    • Clear Bronze + Vision + Adult Dental - HMO
    • Clear Gold - HMO
  • Ambetter from Sunshine Health

    • Ambetter Virtual Access Bronze (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Ambetter from Superior HealthPlan

    • Clear VALUE Silver - HMO
    • Complete VALUE Silver - HMO
    • Everyday VALUE Gold - HMO
    • Focused VALUE Silver - HMO
    • Standard Gold VALUE - HMO
  • Ambetter of Alabama

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
  • Ambetter of Tennessee

    • Standard Expanded Bronze SELECT - EPO
    • Standard Gold SELECT - EPO
    • Standard Silver SELECT - EPO
  • AmeriHealth Caritas Next

    • AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
    • AmeriHealth Caritas Next Expanded Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
    • AmeriHealth Caritas Next Expanded Bronze Premier + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals Plan - HMO
    • AmeriHealth Caritas Next Gold Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
    • AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals - HMO
  • AvMed

    • AvMed Entrust Bronze 600 (2024) - HMO
    • AvMed Entrust Bronze 625 Dental+Vision (2024) - HMO
    • AvMed Entrust Bronze 650 (2024) - HMO
    • AvMed Entrust Expanded Bronze Standard (2024) - HMO
    • AvMed Entrust Gold 125 (2024) - HMO
  • Cigna Healthcare

    • Connect Bronze 0 Indiv Med Deductible - EPO
    • Connect Bronze 5500 Indiv Med Deductible - EPO
    • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
  • Florida Blue (BlueCross BlueShield FL)

    • BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx) - PPO
    • BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$) - PPO
  • Florida Blue HMO (a BlueCross BlueShield FL company)

    • BlueCare Bronze (HSA) 24K01-09 (Rewards $$$ / $4 Condition Care Rx) - POS
    • BlueCare Bronze 24K01-03 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) - POS
    • BlueCare Bronze 24K01-05 ($0 Virtual Visits / Rewards $$$) - POS
    • BlueCare Bronze 24K01-25 ($0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$) - POS
    • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards $$$) - POS
  • Molina Healthcare

    • Bronze 4 - HMO
    • Bronze 8 - HMO
    • Gold 1 - HMO
    • Gold 1 with Adult Vision Services - HMO
    • Gold 8 - HMO
  • Oscar Insurance Company of Florida

    • Bronze Classic - EPO
    • Bronze Classic 4700 - EPO
    • Bronze Classic Standard - EPO
    • Bronze Elite + PCP Saver Plus - EPO
    • Bronze Elite + Specialist Saver Plus - EPO
  • UnitedHealthcare

    • UHC Bronze Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) - HMO
    • UHC Gold Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) - HMO
    • UHC Silver Virtual First (Unlimited $0 App-based Care, $3 Tier 2 Rx) (Disponible en espanol) - HMO
  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
CF534YMEDICARE UPIN (02)FL 
001279800MEDICAID (05)FL 

PECOS Enrollment and Medicare Participation Status

Rhea Sancassani is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 143366492

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090930000409

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 33136 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $147.71
  • Minimum New Patient Price $63.97
  • Maximum New Patient Price $195.27
  • Average New Patient Copayment $36.92
  • Minimum New Patient Copayment $15.99
  • Maximum New Patient Copayment $48.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $112.41
  • Minimum Established Patient Price $19.18
  • Maximum Established Patient Price $157.53
  • Average Established Patient Copayment $28.1
  • Minimum Established Patient Copayment $4.79
  • Maximum Established Patient Copayment $39.38

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.02 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 90.61

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 972

    Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)

  • 107

    Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)

  • 20

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Rhea Sancassani is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
JACKSON HEALTH SYSTEM1611 NW 12TH AVE
MIAMI, FL 33136
(305) 585-1111Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003017112
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003011412
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 1 + 1 + 4 + 1 + 2 + 24 = 38
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
40 - 38 = 22

The NPI number 1003017112 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003017112, enumerated in the NPI registry as an "individual" on May 29, 2007

The provider is located at 1801 Nw 9th Ave Ste 209 Miami, Fl 33136 and the phone number is (786) 466-8490

The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease

The provider has more than 18 years of experience. She graduated from University Of Miami, Lm Miller School Of Medicine in 2006.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $147.71 with an average copayment of $36.92 for new patient appointments. Established patients should expect a typical charge of $112.41 and an average copayment of 28.1. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report, Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function and Routine ekg using at least 12 leads including interpretation and report.

The practitioner is affiliated to the following hospital(s): JACKSON HEALTH SYSTEM. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 29, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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