KARN GUPTA MD
NPI 1104841436
Internal Medicine - Nephrology in Rocky Mount, NC

Medicare Participation & PECOS Enrollment Status

Karn Gupta 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.

Karn Gupta 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: 4981704699

  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: I20110718000252

  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.

Balloon dilation of artery with review by radiologist, initial artery

Balloon dilation of an artery is a procedure where a small balloon is inserted into a narrowed artery and inflated to widen it. This improves blood flow. A radiologist reviews the procedure to ensure its success. It's typically the first artery treated.

This service was performed 21 times for 15 patients

Balloon dilation of dialysis segment with review by radiologist

Balloon dilation of a dialysis segment is a procedure where a tiny balloon is inserted and inflated in a narrowed area of your dialysis access site, improving blood flow. A radiologist reviews images to ensure success.

This service was performed 96 times for 49 patients

Balloon dilation of vein with review by radiologist, initial vein

Balloon dilation of a vein is a procedure where a small balloon is inserted into a narrowed vein. Once in place, the balloon is inflated to widen the vein and improve blood flow. The procedure is overseen by a radiologist, who uses imaging techniques to ensure accurate placement of the balloon. This is done on the initial vein requiring treatment.

This service was performed 47 times for 31 patients

Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access

This procedure involves using ultrasound technology to evaluate the blood flow in your arteries and veins prior to a hemodialysis access operation. It helps ensure the selected site is suitable for creating a reliable access for dialysis treatment.

This service was performed 18 times for 18 patients

Fluoroscopic guidance for insertion or removal of central vein access device

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

This service was performed 18 times for 16 patients

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.

This service was performed 244 times for 131 patients

Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist

This procedure involves placing a needle or tube into your hemodialysis circuit, a system used to clean your blood when kidneys are not working properly. A stent, a small tube, is then inserted into the dialysis segment to keep it open. A radiologist reviews the process to ensure accuracy.

This service was performed 68 times for 57 patients

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, which is part of the system that cleans your blood when your kidneys can't. A radiologist, a doctor specialized in imaging techniques, will review the process to ensure everything is correct.

This service was performed 22 times for 17 patients

Insertion of tube into chest or arm artery, each first order branch

This procedure involves placing a thin tube into a chest or arm artery. It is done to monitor blood pressure, take blood samples, or deliver medications. The tube may also be inserted into each first order branch, which are the initial divisions of the main artery.

This service was performed 90 times for 55 patients

Insertion of tunneled central venous tube for infusion (5 years or older)

The insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.

This service was performed 16 times for 15 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 15,381 times for 188 patients

Permanent blockage of hemodialysis circuit with review by radiologist

This is a procedure where a radiologist reviews the permanent blockage of your hemodialysis circuit. Hemodialysis is a treatment that uses a machine to clean your blood when your kidneys can't. A blockage can prevent this process, which may need review or intervention.

This service was performed 16 times for 16 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist

This is a procedure to improve your dialysis treatment. If a blood clot blocks your dialysis circuit, it's removed or dissolved. If the dialysis segment is narrow, a balloon is used to widen it. Sometimes, a stent is placed to keep it open. A radiologist reviews all these steps to ensure accuracy.

This service was performed 33 times for 27 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube

This procedure involves eliminating a blood clot in your hemodialysis circuit, ensuring smooth blood flow. A balloon tube is used to widen the dialysis segment if needed. Images are taken and reviewed by a radiologist to confirm successful completion.

This service was performed 29 times for 25 patients

Removal of tunneled central venous tube

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

This service was performed 42 times for 42 patients

Replacement of tunneled central venous tube

A tunneled central venous tube replacement is a procedure where an existing tube, used to deliver medication or nutrition directly to a large vein, is replaced. This is done under local anesthesia and involves inserting a new tube through a small incision.

This service was performed 49 times for 32 patients

Review by radiologist of arm or leg artery image

This procedure involves a radiologist examining images of your arm or leg arteries. These images are obtained through a non-invasive method, like an ultrasound or CT scan. The radiologist reviews these images to identify any abnormalities, such as blockages or narrowing, which can affect blood flow.

This service was performed 77 times for 52 patients

Review by radiologist of major upper body vein image

This procedure involves a radiologist examining images of your upper body's major veins. This aids in identifying any abnormalities or issues that may affect your health. The process is non-invasive, painless, and provides crucial information for your healthcare.

This service was performed 43 times for 30 patients

Ultrasonic guidance for blood vessel access

Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.

This service was performed 19 times for 16 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 495 times for 198 patients

Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes

This service involves a physician administering medication to lower your consciousness during a procedure. It's done for your comfort and safety. The drug's effects last about 15 minutes, so additional doses may be given as needed.

This service was performed 88 times for 40 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $23.98 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 27804 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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