PETER CAMPBELL GREGORY MD
NPI 1013969856
Internal Medicine - Nephrology in Federal Way, WA

Medicare Participation & PECOS Enrollment Status

Peter Gregory 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.

Peter Gregory 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: 3779518535

  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: I20061012000139

  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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Balloon dilation of dialysis segment with review by radiologist

Balloon dilation of a dialysis segment is a procedure where a tiny balloon is inserted and inflated in a narrowed area of your dialysis access site, improving blood flow. A radiologist reviews images to ensure success.

This service was performed 64 times for 38 patients

Balloon dilation of vein with review by radiologist, initial vein

Balloon dilation of a vein is a procedure where a small balloon is inserted into a narrowed vein. Once in place, the balloon is inflated to widen the vein and improve blood flow. The procedure is overseen by a radiologist, who uses imaging techniques to ensure accurate placement of the balloon. This is done on the initial vein requiring treatment.

This service was performed 14 times for 11 patients

Chemical destruction of first incompetent vein of arm or leg using imaging guidance

This procedure involves using a chemical to close off a malfunctioning vein in your arm or leg. Imaging guidance is used to accurately locate the vein. This helps improve blood flow by rerouting it through healthier veins.

This service was performed 13 times for 12 patients

Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.

This service was performed 21 times for 21 patients

Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access

This procedure involves using ultrasound technology to examine the blood flow in your arteries and veins on both sides of your body. It's crucial for preparing for hemodialysis access, ensuring safe and effective treatment.

This service was performed 16 times for 16 patients

Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance

This procedure involves using radiofrequency energy, a type of heat energy, to close off an unhealthy vein in your arm or leg. Imaging guidance helps ensure precise targeting of the vein. This helps improve blood flow by rerouting it through healthier veins.

This service was performed 13 times for 11 patients

Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance

This procedure involves using radiofrequency energy, a type of heat energy, to close off an unhealthy vein in your arm or leg. Imaging guidance helps ensure precise targeting of the vein. This helps improve blood flow by rerouting it through healthier veins.

This service was performed 23 times for 18 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 48 times for 40 patients

Fluoroscopic guidance for insertion or removal of central vein access device

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

This service was performed 28 times for 24 patients

Injection of chemical agent into multiple incompetent veins of leg

This procedure involves injecting a special chemical into problematic veins in the leg. The chemical helps to close off these veins, rerouting blood through healthier veins. This can alleviate discomfort and improve the appearance of the treated area.

This service was performed 20 times for 14 patients

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.

This service was performed 226 times for 150 patients

Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist

This procedure involves placing a needle or tube into your hemodialysis circuit, a system used to clean your blood when kidneys are not working properly. A stent, a small tube, is then inserted into the dialysis segment to keep it open. A radiologist reviews the process to ensure accuracy.

This service was performed 16 times for 15 patients

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, which is part of the system that cleans your blood when your kidneys can't. A radiologist, a doctor specialized in imaging techniques, will review the process to ensure everything is correct.

This service was performed 28 times for 24 patients

Insertion of tube into chest or arm artery, each first order branch

This procedure involves placing a thin tube into a chest or arm artery. It is done to monitor blood pressure, take blood samples, or deliver medications. The tube may also be inserted into each first order branch, which are the initial divisions of the main artery.

This service was performed 70 times for 55 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 21 times for 21 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist

This is a procedure to improve your dialysis treatment. If a blood clot blocks your dialysis circuit, it's removed or dissolved. If the dialysis segment is narrow, a balloon is used to widen it. Sometimes, a stent is placed to keep it open. A radiologist reviews all these steps to ensure accuracy.

This service was performed 13 times for 13 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube

This procedure involves eliminating a blood clot in your hemodialysis circuit, ensuring smooth blood flow. A balloon tube is used to widen the dialysis segment if needed. Images are taken and reviewed by a radiologist to confirm successful completion.

This service was performed 27 times for 19 patients

Removal of tunneled central venous tube

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

This service was performed 20 times for 20 patients

Replacement of tunneled central venous tube

A tunneled central venous tube replacement is a procedure where an existing tube, used to deliver medication or nutrition directly to a large vein, is replaced. This is done under local anesthesia and involves inserting a new tube through a small incision.

This service was performed 16 times for 12 patients

Review by radiologist of arm or leg artery image

This procedure involves a radiologist examining images of your arm or leg arteries. These images are obtained through a non-invasive method, like an ultrasound or CT scan. The radiologist reviews these images to identify any abnormalities, such as blockages or narrowing, which can affect blood flow.

This service was performed 61 times for 49 patients

Ultrasonic guidance for blood vessel access

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

This service was performed 151 times for 104 patients

Ultrasonic guidance for needle placement

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

This service was performed 34 times for 26 patients

Ultrasound of both sides of head and neck blood flow

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

This service was performed 16 times for 16 patients

Ultrasound of hemodialysis access

An ultrasound of hemodialysis access is a non-invasive procedure that uses sound waves to create images of your dialysis access site. It helps monitor the access site's health and detect any potential issues like blockages or narrowing.

This service was performed 52 times for 40 patients

Ultrasound of leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

This service was performed 19 times for 19 patients

Ultrasound study of arm and leg arteries

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

This service was performed 26 times for 25 patients

Ultrasound study of arm or leg veins with compression and maneuvers

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

This service was performed 33 times for 31 patients

Ultrasound study of one arm or leg veins with compression and maneuvers

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

This service was performed 74 times for 52 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 221 times for 149 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.94 for a new patient copayment and $27.75 for an established patient copayment.

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 98001 ZIP code area.

* 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 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 provider also has detailed performance information the following quality measures: .

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 comprises 40% of a provider's final MIPS score.
  
  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 comprises 25% of a provider's final MIPS score.
  
  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 comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: N/A

  The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.

MIPS Quality Measures

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