DR. DANIELA M CARLOS PONS MD
NPI 1043537145
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Caguas, PR

Medicare Participation & PECOS Enrollment Status

Daniela Carlos Pons 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.

Daniela Carlos Pons 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: 8123391885

  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: I20171102001069

  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.

Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies

This procedure helps to measure the pressure inside your bladder while passing fluid. It checks how well your bladder and the tube that carries fluid from your bladder are working. It's important for diagnosing issues with fluid flow and storage.

This service was performed 17 times for 17 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 14 times for 14 patients

Electronic assessment of bladder emptying

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

This service was performed 17 times for 17 patients

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 95 times for 55 patients

Insertion of device into abdomen with pressure and urine flow rate study

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

This service was performed 17 times for 17 patients

Insertion of temporary bladder tube

This procedure involves placing a small tube into your lower abdomen to help drain urine from your bladder. It's a temporary measure, often used when normal urination is not possible. The tube remains in place until you can urinate on your own again.

This service was performed 29 times for 29 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 19 times for 19 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 26 times for 26 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

This service was performed 17 times for 17 patients

Ultrasound measurement of bladder capacity after voiding

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

This service was performed 41 times for 29 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.66 for a new patient copayment and $17.72 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 00725 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.

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