PATRICIA ELLEN RILEY MD
NPI 1013985746
Physical Medicine & Rehabilitation in Philadelphia, PA

Medicare Participation & PECOS Enrollment Status

Patricia Riley 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.

Patricia Riley 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: 7315980521

  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: I20050608000923

  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

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, test socket, below knee (HCPCS:L5620)

  1 DME suppliers used 20 Medicare Claims 28 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, acrylic socket (HCPCS:L5629)

  1 DME suppliers used 15 Medicare Claims 18 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, total contact (HCPCS:L5637)

  1 DME suppliers used 18 Medicare Claims 21 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, flexible inner socket, external frame (HCPCS:L5645)

  1 DME suppliers used 14 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert (HCPCS:L5671)

  1 DME suppliers used 13 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism (HCPCS:L5673)

  1 DME suppliers used 13 Medicare Claims 34 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, alignable system (HCPCS:L5910)

  1 DME suppliers used 18 Medicare Claims 21 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) (HCPCS:L5940)

  1 DME suppliers used 15 Medicare Claims 18 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sheath, below knee, each (HCPCS:L8400)

  1 DME suppliers used 15 Medicare Claims 96 Services Paid

• DME-Orthotic Devices (DF003N)

  Prosthetic sock, multiple ply, below knee, each (HCPCS:L8420)

  1 DME suppliers used 19 Medicare Claims 138 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic shrinker, below knee, each (HCPCS:L8440)

  1 DME suppliers used 16 Medicare Claims 66 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, single ply, fitting, below knee, each (HCPCS:L8470)

  1 DME suppliers used 19 Medicare Claims 138 Services Paid

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.

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 53 times for 22 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 69 times for 25 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 31 times for 26 patients

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