BILAL SAULAT M.D.,
NPI 1013081702
Psychiatry & Neurology - Neurology in Reading, PA


Quality Rating: 100 out of 100 score

NPI Status: Active since November 17, 2006

Contact Information

301 S 7TH AVE
SUITE 210
READING, PA
ZIP 19611
Phone: (484) 628-4656
Fax: (484) 628-4657

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  • Individual
  • Male
  • Years of Experience 27
  • Psychiatry & Neurology
  • Neurology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About BILAL SAULAT

Bilal Saulat is a provider established in Reading, Pennsylvania and his medical specialization is Psychiatry & Neurology with a focus in neurology with more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1013081702 assigned on November 2006. The practitioner's primary taxonomy code is 2084N0400X with license number MD456024 (PA). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1013081702
Provider Name
BILAL SAULAT M.D.,
Other Name
BILAL SAULAT
Other Name Type
Other Name (5)
Gender
Male
Entity Type
Individual
Location Address
301 S 7TH AVE SUITE 210 READING, PA 19611
Location Phone
(484) 628-4656
Location Fax
(484) 628-4657
Mailing Address
PO BOX 13579 READING, PA 19612
Mailing Phone
(484) 628-0796
Mailing Fax
(484) 628-4657
Medical School Name
OTHER
Graduation Year
1997
Is Sole Proprietor?
No
Enumeration Date
11-17-2006
Last Update Date
03-08-2016
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Bilal Saulat 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 100, 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 following quality measures were reported for this provider: care plan.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.93 for a new patient copayment and $25.4 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

Psychiatry & Neurology Neurology

Taxonomy Code
2084N0400X
Type
Allopathic & Osteopathic Physicians
License No.
MD456024
License State
PA
Taxonomy Description
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

125-046979 (IL)
22084N0008XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neuromuscular Medicine

D0069838 (MD)
32084N0400XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurology

J00214174 (AL)
42084N0400XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Neurology

D0069838 (MD)
52084S0012XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Sleep Medicine

D0069838 (MD)

Insurance Plans Accepted

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

  • 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
446488MEDICARE PIN (08)PA 
103060177MEDICAID (05)PA 

PECOS Enrollment and Medicare Participation Status

Bilal Saulat 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: 3577752286

    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: I20151030000151

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    7 DME suppliers used 119 Medicare Claims 119 Services Paid

  • Other DME (D1E)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    7 DME suppliers used 70 Medicare Claims 70 Services Paid

  • Other DME (D1E)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    7 DME suppliers used 106 Medicare Claims 163 Services Paid

  • Other DME (D1E)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    6 DME suppliers used 41 Medicare Claims 152 Services Paid

  • Other DME (D1E)

    Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

    7 DME suppliers used 25 Medicare Claims 70 Services Paid

  • Other DME (D1E)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    8 DME suppliers used 48 Medicare Claims 48 Services Paid

  • Other DME (D1E)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    9 DME suppliers used 93 Medicare Claims 93 Services Paid

  • Other DME (D1E)

    Tubing used with positive airway pressure device (HCPCS:A7037)

    8 DME suppliers used 22 Medicare Claims 22 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    9 DME suppliers used 170 Medicare Claims 550 Services Paid

  • Other DME (D1E)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    7 DME suppliers used 21 Medicare Claims 21 Services Paid

  • Other DME (D1E)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    9 DME suppliers used 72 Medicare Claims 72 Services Paid

  • Other DME (D1E)

    Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0471)

    2 DME suppliers used 26 Medicare Claims 26 Services Paid

  • Other DME (D1E)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    6 DME suppliers used 115 Medicare Claims 117 Services Paid

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 19611 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $131.75
  • Minimum New Patient Price $57.02
  • Maximum New Patient Price $174.05
  • Average New Patient Copayment $32.93
  • Minimum New Patient Copayment $14.25
  • Maximum New Patient Copayment $43.51

Established Patients Visit Costs *

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

  • Average Established Patient Price $101.62
  • Minimum Established Patient Price $17.59
  • Maximum Established Patient Price $142.08
  • Average Established Patient Copayment $25.4
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $35.52

* 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: 100 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: 100

    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: 100

    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.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care Plan 26% 61
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan

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.

  • 31

    Needle measurement and recording of electrical activity of muscles of arm or leg complete study (HCPCS:95886)

  • 27

    Sleep monitoring of patient (6 years or older) in sleep lab (HCPCS:95810)

  • 19

    Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube (HCPCS:95811)

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. Bilal Saulat is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
RIDDLE MEMORIAL HOSPITAL1068 WEST BALTIMORE PIKE
MEDIA, PA 19063
(610) 566-9400Acute Care Hospitals

Reviews for BILAL SAULAT M.D.,

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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.
1013081702
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
202308270
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 8 + 2 + 7 + 0 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1013081702 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1891799243 GERARD L. HELINEK M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-5982
1346244720 JOSEPH W. BURKE M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8044
1750386306 JOHN E. CARLSON M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8925
1013912666 GAIL A. LUECKE M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8108
1659376200 ELIZABETH O'NEILL-RICE M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8108
1194720748 BRENT J. WAGNER M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8919
1003811654 RANDALL S. WINN M.D.
Individual
Specialist301 S 7TH AVE STE 135
WEST READING, PA 19611
(610) 988-8929
1366440513 JOHN MICHAEL PENTA MD
Individual
Otolaryngology301 S 7TH AVE SUITE 305
WEST READING, PA 19611
(610) 376-6990
1356342836MRS. SARA J WILHELM PA
Individual
Physician Assistant301 S 7TH AVE STE 3220
WEST READING, PA 19611
(610) 376-8671
1003817545MR. TIMOTHY W MYERS PT
Individual
Physical Therapist301 S 7TH AVE STE 3220
WEST READING, PA 19611
(610) 376-8671
1235121252MRS. KAREN S STEHMAN PA C
Individual
Physician Assistant301 S 7TH AVE STE 3220
WEST READING, PA 19611
(610) 376-8671
1740273861 WAYNE CALVIN DEVOS MD, PHD
Individual
Colon & Rectal Surgery301 S 7TH AVE SUITE 100
WEST READING, PA 19611
(610) 375-6001
1871586925 VINCENT JOHN MOFFITT MD
Individual
Pediatrics301 S 7TH AVE STE 3170
WEST READING, PA 19611
(610) 374-4491
1063405165 FRANK MOULTON CARTER MD
Individual
Colon & Rectal Surgery301 S 7TH AVE SUITE 100
WEST READING, PA 19611
(610) 375-6001
1336132323BERKS COLORECTAL SURGICAL ASSOCIATES
Organization
Colon & Rectal Surgery301 S 7TH AVE SUITE 100
WEST READING, PA 19611
(610) 375-6001
1063403251DR. MICHAEL ANTHONY ROMEO DO
Individual
Radiology (Diagnostic Radiology)301 S 7TH AVE STE. 135
WEST READING, PA 19611
(610) 988-8936
1437130838 MICHAEL PAUL FEIGHTNER M.D.
Individual
Radiology (Diagnostic Radiology)301 S 7TH AVE SUITE 135
WEST READING, PA 19611
(610) 988-8157
1730163411 PAUL D MITNICK MD
Individual
Internal Medicine (Nephrology)301 S 7TH AVE STE 355
WEST READING, PA 19611
(610) 376-7365
1205815735 RANDOLPH S PALLAS M.D.
Individual
Specialist301 S 7TH AVE SUITE 2020
WEST READING, PA 19611
(610) 375-6565
1245219328FLYNN & HANLEY SURGICAL ASSOCIATES, P.C.
Organization
Specialist301 S 7TH AVE SUITE 3070
WEST READING, PA 19611
(610) 375-4381

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013081702, enumerated in the NPI registry as an "individual" on November 17, 2006

The provider is located at 301 S 7th Ave Suite 210 Reading, Pa 19611 and the phone number is (484) 628-4656

The provider's speciality is Psychiatry & Neurology with taxonomy code 2084N0400X with a focus in Neurology

The provider has more than 27 years of experience.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 11, 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 , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $131.75 with an average copayment of $32.93 for new patient appointments. Established patients should expect a typical charge of $101.62 and an average copayment of 25.4. 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: Needle measurement and recording of electrical activity of muscles of arm or leg complete study, Sleep monitoring of patient (6 years or older) in sleep lab and Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube.

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

This NPI record was last updated on November 17, 2006. 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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