CAROL TRAN PA
NPI 1043216179
Physician Assistant - Medical in Albuquerque, NM

Medicare Participation & PECOS Enrollment Status

Carol Tran 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.

Carol Tran 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: 345262325

  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: I20161205000050

  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-Other DME (DE001N)

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

  17 DME suppliers used 253 Medicare Claims 253 Services Paid

• DME-Other DME (DE001N)

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

  12 DME suppliers used 220 Medicare Claims 220 Services Paid

• DME-Other DME (DE001N)

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

  12 DME suppliers used 215 Medicare Claims 525 Services Paid

• DME-Other DME (DE001N)

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

  9 DME suppliers used 117 Medicare Claims 594 Services Paid

• DME-Other DME (DE001N)

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

  9 DME suppliers used 92 Medicare Claims 471 Services Paid

• DME-Other DME (DE001N)

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

  14 DME suppliers used 235 Medicare Claims 235 Services Paid

• DME-Other DME (DE001N)

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

  14 DME suppliers used 259 Medicare Claims 259 Services Paid

• DME-Other DME (DE001N)

  Chinstrap used with positive airway pressure device (HCPCS:A7036)

  5 DME suppliers used 31 Medicare Claims 31 Services Paid

• DME-Other DME (DE001N)

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

  9 DME suppliers used 162 Medicare Claims 162 Services Paid

• DME-Other DME (DE001N)

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

  18 DME suppliers used 445 Medicare Claims 2466 Services Paid

• DME-Other DME (DE001N)

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

  7 DME suppliers used 57 Medicare Claims 57 Services Paid

• DME-Other DME (DE001N)

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

  14 DME suppliers used 207 Medicare Claims 207 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

  3 DME suppliers used 21 Medicare Claims 21 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  6 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  5 DME suppliers used 148 Medicare Claims 165 Services Paid

• DME-Other DME (DE001N)

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

  8 DME suppliers used 268 Medicare Claims 281 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  5 DME suppliers used 115 Medicare Claims 122 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.

Established patient office or other outpatient visit, 20-29 minutes

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 61 times for 57 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 227 times for 191 patients

New patient office or other outpatient visit, 45-59 minutes

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 75 times for 75 patients

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