NATHANIEL LYLE HALL M.D.
NPI 1063695948
Internal Medicine - Interventional Cardiology in Kalispell, MT

Medicare Participation & PECOS Enrollment Status

Nathaniel Hall 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.

Nathaniel Hall 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: 5092958561

  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: I20160620002304

  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.

Anticoagulant management of patient taking warfarin

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

This service was performed 187 times for 29 patients

Coronary angioplasty and stenting

Coronary angioplasty and stenting is a procedure to open narrowed or blocked heart arteries. A thin tube is inserted into a blood vessel, usually in the leg or arm, and guided to the heart. A small balloon at the end of the tube is inflated to widen the artery. A stent, a small wire mesh tube, may be placed in the artery to keep it open.

This service was performed for 57 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 40 times for 40 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 228 times for 203 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 38 times for 34 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days

This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.

This service was performed 129 times for 56 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.

This service was performed 38 times for 13 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

This service was performed 13 times for 12 patients

Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch

This procedure involves placing a small, mesh tube (stent) in your coronary artery to keep it open. A balloon is used to expand the stent and artery, improving blood flow to your heart. It's typically done for a single artery or branch.

This service was performed 76 times for 58 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

This service was performed 35 times for 35 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

This service was performed 122 times for 121 patients

Insertion of tube in right and left heart chambers and coronary artery for diagnosis with review by radiologist

This procedure involves placing a tube into the heart chambers and coronary artery. It helps diagnose heart conditions. A radiologist reviews the images obtained. It's a standard, safe procedure performed by experienced medical professionals.

This service was performed 11 times for 11 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 47 times for 47 patients

Pacemaker insertion or repair

Pacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.

This service was performed for 20 patients

Programming of dual lead pacemaker system

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

This service was performed 17 times for 14 patients

Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel

This procedure involves using ultrasound technology to examine the first blood vessel of your heart. It helps identify any abnormalities or issues, providing crucial information for diagnosis or treatment. It's a safe, non-invasive process.

This service was performed 27 times for 27 patients

Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel

This procedure involves using ultrasound technology to examine the first vessel of your heart or graft. A radiologist will review the images. It's a non-invasive way to check the health of your heart's blood vessels.

This service was performed 21 times for 21 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 174 times for 168 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.63 for a new patient copayment and $25.04 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 59901 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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nathaniel Hall is affiliated with the following medical facilities:

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