DR. MICHAEL BLAIR MONAHAN D.O.
NPI 1114213428
Urology in Albany, GA

Q: What is Michael Monahan's NPI number?

The NPI number for Michael Monahan is 1114213428. It was assigned to this individual provider in the NPPES registry on June 24, 2011.

Q: What is Michael Monahan's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Monahan was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 24, 2011PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

2400 OSLER CT, ALBANY, GA 31707(229) 449-1676(229) 432-7583 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 16, 2026, Aug 21, 2018, Jun 13, 2016 (3 updates tracked since 2016).

On this page

About Dr. Michael Blair Monahan D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL BLAIR MONAHAN D.O. (NPI 1114213428) is an individual urology provider in Albany, Georgia, licensed in South Carolina (91355) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Phoebe Putney Memorial Hospital, and maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1114213428

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. MICHAEL BLAIR MONAHANCredential: D.O.

Location Address2400 OSLER CTAlbany, GA 31707

Mailing Address2400 Osler CtAlbany, GA 31707-0205 · (229) 449-1676 · Fax (229) 432-7583

Phone(229) 449-1676

Fax(229) 432-7583

Sole ProprietorYes

Medical School CMSWest Virginia School Of Osteopathic MedicineGraduated 2011

Enumeration DateJune 24, 2011

Last NPPES UpdateJuly 16, 20263 updates tracked since enumeration

NPPES CertifiedJuly 16, 2026

✔ NPI 1114213428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in SC · 91355✔ Licensed in MI · 5101019165

Definition

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.

2400 OSLER CT, Albany, GA 31707

Open in Google Maps ↗

Secondary Practice Location 1

Location 1114 Gateway Corp Blvd Ste 330Columbia, SC 29203-9785 · Phone (803) 400-5010

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., BlueCross BlueShield of South Carolina, First Choice Next and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Blair Monahan D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234421066

PECOS Enrollment IDI20160714000911, I20250819000376

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Michael Monahan reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Albany Urology Clinic

Same address

Urology

2400 OSLER CT
Albany, GA 31707

Reassigned Medicare billing, Georgia enrollment
10 clinicians in this Medicare group

NPI 1043383623 (229) 883-1503

Albany Urology Surgery Center LLC

0.1 mi

Ambulatory Surgical

2400 OSLER COURT
Albany, GA 31707

Reassigned Medicare billing, Georgia enrollment
6 clinicians in this Medicare group

NPI 1346685666 (229) 883-1503

Tift Regional Health System Inc

41 mi

School

1464 CARPENTER ROAD S
Tifton, GA 31793

Reassigned Medicare billing, Georgia enrollment
380 clinicians in this Medicare group

NPI 1508428442 (229) 353-2227

Tift Regional Health System Inc

44 mi

Physical Medicine & Rehabilitation

2227 US HIGHWAY 41 N
Tifton, GA 31794

Reassigned Medicare billing, Georgia enrollment
337 clinicians in this Medicare group

NPI 1396095428 (229) 386-4200

Archbold Medical Group

51 mi

Internal Medicine

1090 5TH ST SE
Cairo, GA 39828

Reassigned Medicare billing, Georgia enrollment
96 clinicians in this Medicare group

NPI 1265798185 (229) 377-1100

Floyd Healthcare Management Inc

190 mi

General Acute Care Hospital

304 TURNER MCCALL BLVD SW
Rome, GA 30165

Reassigned Medicare billing, Georgia enrollment
Medicare enrollment name: Floyd Physicians LLC
185 clinicians in this Medicare group

NPI 1154377166 (706) 509-5000

Anmed Health

213 mi

Family Medicine

111 W PINE GROVE RD
Fair Play, SC 29643

Reassigned Medicare billing, South Carolina enrollment
381 clinicians in this Medicare group

NPI 1316263007 (864) 972-0414

Musc Community Physicians

220 mi

Internal Medicine

506 NORTH ST
Bamberg, SC 29003

Reassigned Medicare billing, South Carolina enrollment
2,389 clinicians in this Medicare group

NPI 1841878006 (803) 245-6290

Halifax Healthcare Systems Inc

252 mi

Family Medicine

303 N CLYDE MORRIS BLVD
Daytona Beach, FL 32114

Reassigned Medicare billing, Florida enrollment
786 clinicians in this Medicare group

NPI 1245283530 (386) 254-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 59

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chemical analysis using spectrophotometry (light) 84311

Spectrophotometry is a scientific method used to measure how much a chemical substance absorbs light. This helps in identifying and determining the concentration of that substance in a sample. It's non-invasive, accurate, and used in various medical tests.

3,657 services1,281 patients

Ketone bodies analysis, quantitative 82010

Ketone bodies analysis, quantitative, is a blood test that measures the level of ketones in your body. High levels can indicate diabetes, starvation, or other conditions. This test helps doctors monitor your body's energy use and can guide treatment plans.

2,721 services1,283 patients

Glucose (sugar) level on body fluid 82945

The glucose level in body fluid test measures the amount of sugar in your body's fluids. This test is crucial in managing conditions like diabetes. High or low levels could indicate a health issue that needs attention.

2,720 services1,283 patients

Urine hemoglobin level 83069

The urine hemoglobin level test checks for the presence of hemoglobin, a protein in your red blood cells, in your urine. This test helps identify conditions affecting your blood cells or kidneys. It's non-invasive and involves a routine urine sample.

2,720 services1,283 patients

Urinalysis for bacteria 81007

Urinalysis for bacteria is a test that checks your urine for the presence of bacteria. The test involves collecting a urine sample in a sterile container. The sample is then examined in a lab to identify any bacteria. This helps in diagnosing infections in the urinary system.

2,678 services1,271 patients

Bilirubin level, total 82247

A total bilirubin level test is a blood test that helps check how well your liver is functioning. It measures bilirubin, a yellow substance your body creates when it breaks down red blood cells. High levels may indicate a problem with your liver or bile duct.

2,668 services1,268 patients

Total protein level, urine 84156

The Total Protein Level in urine test measures the amount of protein present in your urine. This helps to check kidney health as high levels may indicate a problem. It's a simple, non-invasive procedure involving a urine sample.

2,667 services1,268 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

2,040 services12 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

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.

1,437 services829 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

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.

1,051 services572 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

520 services398 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

485 services369 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

388 services326 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

232 services208 patients

Testosterone (hormone) level, total 84403

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

181 services123 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

160 services35 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

141 services93 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

114 services107 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

90 services90 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

89 services86 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

74 services70 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

64 services63 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

64 services63 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

58 services26 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

56 services54 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

49 services47 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

47 services20 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

47 services47 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

43 services27 patients

Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique 87500

The detection test by nucleic acid for vancomycin-resistant strep (VRE) is a laboratory procedure. It uses an amplified probe technique to identify specific genetic material in bacteria. This helps determine if the bacteria are resistant to the antibiotic vancomycin.

42 services40 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

41 services33 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

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.

40 services40 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

39 services37 patients

Insertion of sacral nerve neurostimulator electrode array 64561

The insertion of a sacral nerve neurostimulator electrode array is a procedure where a small device is placed under your skin. This device sends mild electrical pulses to your sacral nerves, which can help manage certain body functions and alleviate symptoms.

37 services24 patients

Body fluid ph level 83986

A body fluid pH level test measures the acidity or alkalinity of your body fluids, such as blood or urine. It's crucial for maintaining good health as it can affect your body's ability to carry out vital functions. Imbalances might indicate a health issue.

35 services19 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

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.

35 services34 patients

Cell examination of urine, manual 88120

A cell examination of urine, manually done, is a lab test where your urine is studied under a microscope. This helps identify any abnormal cells or substances in your urine, like bacteria or crystals, that could indicate health issues. It's a simple, non-invasive procedure.

34 services33 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

33 services32 patients

Insertion of implant in urethra within prostate gland using an endoscope, each additional implant 52442

This procedure involves placing additional tiny implants in the prostate gland using a special viewing device. It's a common method to address certain health concerns. The process is done carefully to ensure minimal discomfort.

31 services11 patients

Ultrasound scan of scrotum 76870

An ultrasound scan of the scrotum is a non-invasive imaging test. It uses sound waves to create pictures of the structures within the lower abdominal area. This helps to assess any discomfort or abnormalities you might be experiencing. The procedure is safe and painless.

30 services25 patients

Insertion of tube into ureter using an endoscope through bladder area 52005

This procedure involves the use of a thin, flexible tool called an endoscope. It's inserted through the body's natural pathways to reach the area where urine is transported. A small tube is then placed in this area to help with urine flow or to remove blockages.

29 services26 patients

Detection test for candida species (yeast), amplified probe technique 87481

This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.

27 services27 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

23 services14 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

22 services22 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

20 services18 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

19 services19 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

19 services16 patients

Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver 64590

The insertion of a peripheral or gastric neurostimulator generator is a procedure that helps manage chronic pain or gastric conditions. A small device is surgically placed under the skin, which sends mild electrical signals to the nerves involved.

18 services17 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

16 services16 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

16 services14 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

15 services15 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

15 services12 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

15 services11 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

14 services14 patients

Psa (prostate specific antigen) measurement, free 84154

A PSA measurement, free, is a simple blood test that checks for a specific protein produced by your body. Higher levels may indicate a health concern that needs further investigation. This test is often used to monitor overall wellness.

13 services13 patients

Dilation of urethra using an endoscope 52281

This procedure involves expanding a narrow passage in your urinary tract with the help of a special instrument called an endoscope. It aids in improving urine flow and resolving related issues, ensuring better urinary health.

12 services12 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

12 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

12 services12 patients

Insertion of implant in urethra within prostate gland using an endoscope, 1 implant 52441

This procedure involves placing a small device in the urinary tract using a scope. The device is placed within the prostate gland, which helps manage urinary flow. It's a minimally invasive procedure that aids in improving your comfort and health.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Phoebe Putney Memorial Hospital

Acute Care Hospitals · Albany, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110007

Location417 Third AvenueAlbany, GA 31703 · Dougherty County

Emergency services Birthing friendly

Musc Medical Center

Acute Care Hospitals · Charleston, SC

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420004

Location169 Ashley AveCharleston, SC 29425 · Charleston County

Emergency services Birthing friendly

Musc Health Columbia Medical Center Downtown

Acute Care Hospitals · Columbia, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420026

Location2435 Forest DriveColumbia, SC 29204 · Richland County

Emergency services

Kershawhealth

Acute Care Hospitals · Camden, SC

3/5 CMS rating

OwnershipProprietary

CMS Certification Number420048

Location1315 Roberts StreetCamden, SC 29020 · Kershaw County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

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

DME-Orthotic Devices · category DF008N

2 suppliers22 claims3,990 services$1.70 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

2 suppliers13 claims38 services$7.94 avg. paid by Medicare

Skin barrier; solid, 4 x 4 or equivalent; each A4362

DME-Orthotic Devices · category DF010N

2 suppliers13 claims460 services$2.84 avg. paid by Medicare

Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432

DME-Orthotic Devices · category DF010N

2 suppliers11 claims340 services$3.46 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALBANY UROLOGY CLINIC

Urology