DR. SAMAY A. DALAL M.D.
NPI 1073650347
Internal Medicine - Pulmonary Disease in Denver, CO
About Dr. Samay A. Dalal M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SAMAY A. DALAL M.D. (NPI 1073650347) is an individual pulmonary disease provider in Denver, Colorado, licensed in Colorado (45194) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2000).
NPPES Registry Identity
Specialties & Licenses 3
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Other Identifiers 2
Medicare Participation & PECOS Enrollment Status
Samay Dalal 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.
Samay Dalal 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: 7416057252
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: I20070710000392
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-Oxygen and Supplies (DC000N)
Stationary oxygen contents, liquid, 1 month's supply = 1 unit (HCPCS:E0442)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable oxygen contents, liquid, 1 month's supply = 1 unit (HCPCS:E0444)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $33.13 for a new patient copayment and $25.5 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 80205 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $132.55
- Minimum New Patient Price $58.06
- Maximum New Patient Price $174.82
- Average New Patient Copayment $33.13
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $43.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.03
- Minimum Established Patient Price $18.88
- Maximum Established Patient Price $142.79
- Average Established Patient Copayment $25.5
- Minimum Established Patient Copayment $4.72
- Maximum Established Patient Copayment $35.69
* 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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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DENVER, CO 80205
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073650347, enumerated as an "individual" on January 30, 2007.
The provider is located at 1375 E 20TH AVE DENVER, CO 80205 and the phone number is (303) 338-4545.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Medicare, Medicaid and Kaiser Health. Please consult your insurance carrier or call the provider to verify.
