DR. WILLIAM HARRY GANS M.D.
NPI 1083616320
Urology in West Palm Beach, FL


Quality Rating: 94.11 out of 100 score

NPI Status: Active since June 01, 2005

Contact Information

525 OKEECHOBEE BLVD
SUITE 1400
WEST PALM BEACH, FL
ZIP 33401
Phone: (561) 804-0200
Fax: (561) 804-0222

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  • Individual
  • Male
  • Years of Experience 28
  • Urology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About WILLIAM GANS

William Gans is a provider established in West Palm Beach, Florida and his medical specialization is Urology with more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1083616320 assigned on June 2005. The practitioner's primary taxonomy code is 208800000X with license number ME87114 (FL). The provider is registered as an individual and his NPI record was last updated 14 years ago.

NPI
1083616320
Provider Name
DR. WILLIAM HARRY GANS M.D.
Gender
Male
Entity Type
Individual
Location Address
525 OKEECHOBEE BLVD SUITE 1400 WEST PALM BEACH, FL 33401
Location Phone
(561) 804-0200
Location Fax
(561) 804-0222
Mailing Address
525 OKEECHOBEE BLVD SUITE 1400 WEST PALM BEACH, FL 33401
Mailing Phone
(561) 804-0200
Mailing Fax
(561) 804-0222
Medical School Name
OTHER
Graduation Year
1997
Is Sole Proprietor?
No
Enumeration Date
06-01-2005
Last Update Date
05-07-2010
Code Navigator

William Gans 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.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.11, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.38 for a new patient copayment and $19.1 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
ME87114
License State
FL
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Aetna CVS Health

    • Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Gold 3: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Gold 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
    • Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
  • Ambetter from Arizona Complete Health

    • Standard Expanded Bronze SELECT - HMO
    • Standard Gold SELECT - HMO
    • Standard Silver SELECT - HMO
  • Ambetter from Peach State Health Plan

    • Choice Bronze HSA - HMO
    • Choice Bronze HSA + Vision + Adult Dental - HMO
    • Clear Bronze - HMO
    • Clear Bronze + Vision + Adult Dental - HMO
    • Clear Gold - HMO
  • Ambetter from Sunshine Health

    • Ambetter Virtual Access Bronze (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Gold (Virtual PCP selection required) - HMO
    • Ambetter Virtual Access Silver (Virtual PCP selection required) - HMO
    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Ambetter from Superior HealthPlan

    • Clear VALUE Silver - HMO
    • Complete VALUE Silver - HMO
    • Everyday VALUE Gold - HMO
    • Focused VALUE Silver - HMO
    • Standard Gold VALUE - HMO
  • Ambetter of Alabama

    • Choice Bronze HSA - EPO
    • Choice Bronze HSA + Vision + Adult Dental - EPO
    • Clear Silver - EPO
    • Clear Silver + Vision + Adult Dental - EPO
    • Elite Bronze - EPO
  • Ambetter of Tennessee

    • Standard Expanded Bronze SELECT - EPO
    • Standard Gold SELECT - EPO
    • Standard Silver SELECT - EPO
  • AvMed

    • AvMed Entrust Bronze 600 (2024) - HMO
    • AvMed Entrust Bronze 625 Dental+Vision (2024) - HMO
    • AvMed Entrust Bronze 650 (2024) - HMO
    • AvMed Entrust Expanded Bronze Standard (2024) - HMO
    • AvMed Entrust Gold 125 (2024) - HMO
  • Cigna Healthcare

    • Connect Bronze 0 Indiv Med Deductible - EPO
    • Connect Bronze 5500 Indiv Med Deductible - EPO
    • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
    • Connect Bronze 8500 Indiv Med Deductible - EPO
    • Connect Bronze CMS Standard - EPO
  • Florida Blue (BlueCross BlueShield FL)

    • BlueOptions Bronze (HSA) 24J01-10 (Rewards $$$ / $4 Condition Care Rx) - PPO
    • BlueOptions Bronze 24J01-04 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-06 ($0 Virtual Visits / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-17 ($0 Virtual Visits / $50 PCP Visits / Rewards $$$) - PPO
    • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards $$$) - PPO
  • Florida Blue HMO (a BlueCross BlueShield FL company)

    • BlueCare Bronze (HSA) 24K01-09 (Rewards $$$ / $4 Condition Care Rx) - POS
    • BlueCare Bronze 24K01-03 ($0 Virtual Visits / 3 PCP Visits for $0 then $40 / Rewards $$$) - POS
    • BlueCare Bronze 24K01-05 ($0 Virtual Visits / Rewards $$$) - POS
    • BlueCare Bronze 24K01-25 ($0 Virtual Visits / $50 PCP Visit / $30 Generic Meds / Rewards $$$) - POS
    • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards $$$) - POS
  • Medicare

  • Medicaid

  • Blue Cross Blue Shield


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
H84953MEDICARE UPIN (02) 
78634OTHER (01)FLBC/BS FLORIDA
78634ZMEDICARE ID-TYPE UNSPECIFIED (04)MEDICARE

PECOS Enrollment and Medicare Participation Status

William Gans 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: 446323679

    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: I20080722000496

    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.

Prosthetic and Orthotic Devices

  • Prosthetic/Orthotic devices (D1F)

    Lubricant, individual sterile packet, each (HCPCS:A4332)

    2 DME suppliers used 23 Medicare Claims 2880 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

    3 DME suppliers used 35 Medicare Claims 7260 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)

    3 DME suppliers used 63 Medicare Claims 10490 Services Paid

  • Prosthetic/Orthotic devices (D1F)

    Lubricant, per ounce (HCPCS:A4402)

    3 DME suppliers used 12 Medicare Claims 87 Services Paid

Physician Visit Costs

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 33401 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $141.52
  • Minimum New Patient Price $61.36
  • Maximum New Patient Price $187
  • Average New Patient Copayment $35.38
  • Minimum New Patient Copayment $15.34
  • Maximum New Patient Copayment $46.75

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $76.4
  • Minimum Established Patient Price $18.68
  • Maximum Established Patient Price $151.65
  • Average Established Patient Copayment $19.1
  • Minimum Established Patient Copayment $4.67
  • Maximum Established Patient Copayment $37.91

* 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.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 94.11 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 88.23

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 283

    Urinalysis, manual test (HCPCS:81002)

  • 253

    Ultrasound measurement of bladder capacity after voiding (HCPCS:51798)

  • 133

    Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope (HCPCS:52000)

  • 20

    Ultrasound of rectum (HCPCS:76872)

  • 19

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 18

    Biopsy of prostate gland (HCPCS:55700)

Hospital Affiliations

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. William Gans is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CLEVELAND CLINIC MARTIN NORTH HOSPITAL200 SE HOSPITAL AVE
STUART, FL 34994
(772) 287-5200Acute Care Hospitals
JUPITER MEDICAL CENTER1210 S OLD DIXIE HWY
JUPITER, FL 33458
(561) 747-2234Acute Care Hospitals
CLEVELAND CLINIC HOSPITAL3100 WESTON RD
WESTON, FL 33331
(954) 689-5000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1083616320
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201631211234
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 6 + 3 + 1 + 2 + 1 + 1 + 2 + 3 + 4 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1083616320 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1699883538DR. DARRYL MILLER MD
Individual
Internal Medicine (Cardiovascular Disease)525 OKEECHOBEE BLVD SUITE 1400
WEST PALM BEACH, FL 33401
(561) 804-0200
1861645921 EVAN R PECK M.D.
Individual
Physical Medicine & Rehabilitation (Sports Medicine)525 OKEECHOBEE BLVD 14TH FLOOR
WEST PALM BEACH, FL 33401
(561) 804-0200
1013076470DR. SAM MICHAEL FARADYAN M.D.
Individual
Internal Medicine (Pulmonary Disease)525 OKEECHOBEE BLVD 14TH FLOOR
WEST PALM BEACH, FL 33401
(561) 804-0200
1427099456DR. THOMAS F MANN MD
Individual
Internal Medicine525 OKEECHOBEE BLVD SUITE 1400
WEST PALM BEACH, FL 33401
(561) 804-0200
1356510762 KARI SUTTER MD
Individual
Internal Medicine (Rheumatology)525 OKEECHOBEE BLVD 14TH FLOOR
WEST PALM BEACH, FL 33401
(561) 804-0200
1023068962 MARY ANN BECK CORSELLO PA
Individual
Physician Assistant (Medical)525 OKEECHOBEE BLVD CITY TOWER PLACE 14TH FLOOR
WEST PALM BEACH, FL 33401
(561) 804-0200
1073516217DR. MARY C LABANOWSKI MD
Individual
Internal Medicine525 OKEECHOBEE BLVD
WEST PALM BEACH, FL 33401
(561) 804-0200
1992113195 ANGELA DRYER ATC, LAT
Individual
Specialist/Technologist (Athletic Trainer)525 OKEECHOBEE BLVD 14TH FLOOR CITY PLACE TOWER
WEST PALM BEACH, FL 33401
(561) 804-0200
1588286629DR. CHRISTOPHER TODD ELDER PHARM.D.
Individual
Pharmacist (Oncology)525 OKEECHOBEE BLVD
WEST PALM BEACH, FL 33401
(951) 551-4573

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083616320, enumerated in the NPI registry as an "individual" on June 01, 2005

The provider is located at 525 Okeechobee Blvd Suite 1400 West Palm Beach, Fl 33401 and the phone number is (561) 804-0200

The provider's speciality is Urology with taxonomy code 208800000X

The provider has more than 28 years of experience.

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arizona Complete. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $141.52 with an average copayment of $35.38 for new patient appointments. Established patients should expect a typical charge of $76.4 and an average copayment of 19.1. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Urinalysis, manual test, Ultrasound measurement of bladder capacity after voiding, Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope, Ultrasound of rectum, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention and Biopsy of prostate gland.

The practitioner is affiliated to the following hospital(s): CLEVELAND CLINIC MARTIN NORTH HOSPITAL, JUPITER MEDICAL CENTER and CLEVELAND CLINIC HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 01, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.