MARY GRACE SENSENG D.O.
NPI 1053842617
Physical Medicine & Rehabilitation in Country Club Hills, IL

Medicare Participation & PECOS Enrollment Status

Mary Grace Senseng 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.

Mary Grace Senseng 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: 2466722707

  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: I20211006003150, I20230830000607, I20240614001496

  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-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Other DME (DE000N)

  Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD000N)

  Standard hemi (low seat) wheelchair (HCPCS:K0002)

  1 DME suppliers used 24 Medicare Claims 24 Services Paid

• DME-Wheelchairs (DD021N)

  Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

  1 DME suppliers used 32 Medicare Claims 32 Services Paid

• DME-Other DME (DE000N)

  Gasket or seal, for use with prosthetic socket insert, any type, each (HCPCS:L7700)

  8 DME suppliers used 12 Medicare Claims 20 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF003N)

  Below knee, molded socket, shin, sach foot, endoskeletal system (HCPCS:L5301)

  24 DME suppliers used 91 Medicare Claims 94 Services Paid

• DME-Orthotic Devices (DF000N)

  Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee (HCPCS:L5321)

  15 DME suppliers used 25 Medicare Claims 25 Services Paid

• DME-Orthotic Devices (DF003N)

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

  30 DME suppliers used 131 Medicare Claims 171 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, test socket, above knee (HCPCS:L5624)

  19 DME suppliers used 49 Medicare Claims 84 Services Paid

• DME-Orthotic Devices (DF003N)

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

  31 DME suppliers used 129 Medicare Claims 132 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, above knee or knee disarticulation, acrylic socket (HCPCS:L5631)

  20 DME suppliers used 52 Medicare Claims 53 Services Paid

• DME-Orthotic Devices (DF003N)

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

  30 DME suppliers used 136 Medicare Claims 141 Services Paid

• DME-Orthotic Devices (DF003N)

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

  24 DME suppliers used 100 Medicare Claims 104 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee suction socket (HCPCS:L5647)

  21 DME suppliers used 81 Medicare Claims 81 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, ischial containment/narrow m-l socket (HCPCS:L5649)

  19 DME suppliers used 54 Medicare Claims 54 Services Paid

• DME-Orthotic Devices (DF000N)

  Additions to lower extremity, total contact, above knee or knee disarticulation socket (HCPCS:L5650)

  21 DME suppliers used 55 Medicare Claims 55 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, above knee, flexible inner socket, external frame (HCPCS:L5651)

  21 DME suppliers used 56 Medicare Claims 56 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower extremity, suction suspension, above knee or knee disarticulation socket (HCPCS:L5652)

  11 DME suppliers used 28 Medicare Claims 28 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)

  21 DME suppliers used 67 Medicare Claims 69 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)

  24 DME suppliers used 70 Medicare Claims 137 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, not for use with locking mechanism (HCPCS:L5679)

  25 DME suppliers used 120 Medicare Claims 236 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each (HCPCS:L5685)

  21 DME suppliers used 87 Medicare Claims 169 Services Paid

• DME-Orthotic Devices (DF003N)

  Replacement, socket, below knee, molded to patient model (HCPCS:L5700)

  18 DME suppliers used 41 Medicare Claims 44 Services Paid

• DME-Orthotic Devices (DF000N)

  Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model (HCPCS:L5701)

  12 DME suppliers used 26 Medicare Claims 26 Services Paid

• DME-Orthotic Devices (DF003N)

  Custom shaped protective cover, below knee (HCPCS:L5704)

  17 DME suppliers used 53 Medicare Claims 54 Services Paid

• DME-Orthotic Devices (DF000N)

  Custom shaped protective cover, above knee (HCPCS:L5705)

  7 DME suppliers used 15 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system (HCPCS:L5781)

  12 DME suppliers used 37 Medicare Claims 38 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control (HCPCS:L5828)

  10 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable (HCPCS:L5845)

  15 DME suppliers used 25 Medicare Claims 25 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability (HCPCS:L5848)

  12 DME suppliers used 20 Medicare Claims 20 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist (HCPCS:L5850)

  11 DME suppliers used 15 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type (HCPCS:L5856)

  10 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Orthotic Devices (DF003N)

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

  28 DME suppliers used 117 Medicare Claims 122 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee or hip disarticulation, alignable system (HCPCS:L5920)

  20 DME suppliers used 48 Medicare Claims 49 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock (HCPCS:L5925)

  9 DME suppliers used 11 Medicare Claims 12 Services Paid

• DME-Orthotic Devices (DF003N)

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

  28 DME suppliers used 117 Medicare Claims 123 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) (HCPCS:L5950)

  19 DME suppliers used 50 Medicare Claims 50 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, flexible protective outer surface covering system (HCPCS:L5962)

  8 DME suppliers used 20 Medicare Claims 21 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature (HCPCS:L5968)

  13 DME suppliers used 41 Medicare Claims 42 Services Paid

• DME-Orthotic Devices (DF003N)

  All lower extremity prostheses, foot, flexible keel (HCPCS:L5972)

  17 DME suppliers used 44 Medicare Claims 45 Services Paid

• DME-Orthotic Devices (DF003N)

  Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source (HCPCS:L5973)

  5 DME suppliers used 12 Medicare Claims 13 Services Paid

• DME-Orthotic Devices (DF003N)

  All lower extremity prostheses, flex-walk system or equal (HCPCS:L5981)

  20 DME suppliers used 55 Medicare Claims 57 Services Paid

• DME-Orthotic Devices (DF000N)

  All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability (HCPCS:L5984)

  8 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Orthotic Devices (DF000N)

  All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) (HCPCS:L5986)

  16 DME suppliers used 26 Medicare Claims 29 Services Paid

• DME-Orthotic Devices (DF000N)

  Addition to lower limb prosthesis, vertical shock reducing pylon feature (HCPCS:L5988)

  7 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Orthotic Devices (DF000N)

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

  11 DME suppliers used 32 Medicare Claims 204 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each (HCPCS:L8417)

  8 DME suppliers used 20 Medicare Claims 114 Services Paid

• DME-Orthotic Devices (DF003N)

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

  27 DME suppliers used 121 Medicare Claims 740 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, multiple ply, above knee, each (HCPCS:L8430)

  13 DME suppliers used 36 Medicare Claims 222 Services Paid

• DME-Orthotic Devices (DF000N)

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

  19 DME suppliers used 38 Medicare Claims 75 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic shrinker, above knee, each (HCPCS:L8460)

  9 DME suppliers used 13 Medicare Claims 26 Services Paid

• DME-Orthotic Devices (DF000N)

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

  27 DME suppliers used 108 Medicare Claims 662 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, single ply, fitting, above knee, each (HCPCS:L8480)

  16 DME suppliers used 40 Medicare Claims 246 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.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 22 times for 16 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 14 times for 11 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 11 times for 11 patients

Follow-up nursing facility visit per day, typically 15 minutes

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

This service was performed 130 times for 39 patients

Follow-up nursing facility visit per day, typically 15 minutes

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

This service was performed 25 times for 11 patients

Follow-up nursing facility visit per day, typically 25 minutes

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

This service was performed 1,332 times for 198 patients

Initial nursing facility visit per day, typically 25 minutes

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

This service was performed 22 times for 19 patients

Initial nursing facility visit per day, typically 35 minutes

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

This service was performed 173 times for 166 patients

Initial nursing facility visit per day, typically 45 minutes

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

This service was performed 22 times for 22 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 181 times for 181 patients

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Frequently Asked Questions