RAUL D RUDELLI MD
NPI 1124049671
Pathology - Clinical Pathology/Laboratory Medicine in West New York, NJ

Medicare Participation & PECOS Enrollment Status

Raul Rudelli 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

• 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.

2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r

This service involves the testing for COVID-19 using advanced technologies that can process multiple samples at once. It identifies different types or subtypes of the virus, including SARS-CoV-2/2019-nCoV. This test is non-CDC but adheres to the guidelines outlined in CMS-2020-01-R.

This service was performed 11 times for 11 patients

Blood test, basic group of blood chemicals (calcium, total)

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

This service was performed 187 times for 170 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 345 times for 311 patients

Cell examination of specimen, selective cellular enhancement technique

Cell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.

This service was performed 2,944 times for 1,861 patients

Cell examination of urine, computer-assisted

A cell examination of urine, computer-assisted, is a lab test where a computer helps analyze your urine sample. It aids in identifying any abnormal cells or substances that may indicate health issues. The process is painless and involves collecting a urine sample.

This service was performed 59 times for 54 patients

Cell examination of urine, manual

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.

This service was performed 1,308 times for 920 patients

Detection of mycoplasma genitalium by dna or rna probe

This procedure involves the use of special probes to identify the presence of a specific bacteria, Mycoplasma Genitalium, in your body. These probes detect the bacteria's unique DNA or RNA, helping to confirm if you have an infection.

This service was performed 1,111 times for 658 patients

Detection test by nucleic acid for cytomegalovirus (cmv), amplified probe technique

A detection test by nucleic acid for cytomegalovirus (CMV) using an amplified probe technique is a lab procedure. It identifies the presence of CMV, a common virus, in your body. This technique amplifies the virus's genetic material, making it easier to detect.

This service was performed 20 times for 17 patients

Detection test by nucleic acid for herpes simplex virus, amplified probe technique

This test uses an amplified probe technique to identify the presence of the herpes simplex virus in your body. It works by detecting the virus's genetic material, or nucleic acid. The test is accurate, reliable, and can help in early detection and treatment.

This service was performed 21 times for 17 patients

Detection test by nucleic acid for herpes virus-6, amplified probe technique

A detection test by nucleic acid for herpes virus-6, amplified probe technique, is a lab procedure that identifies the presence of herpes virus-6 in your body. It does this by amplifying and detecting the virus's genetic material, aiding in accurate diagnosis and treatment planning.

This service was performed 20 times for 17 patients

Detection test by nucleic acid for mycobacteria tuberculosis (tb bacteria), amplified probe technique

A detection test by nucleic acid for Mycobacteria Tuberculosis, using an amplified probe technique, is a diagnostic test for TB. It identifies the TB bacteria's genetic material in your body. It's fast, highly accurate, and can confirm TB presence even in small samples.

This service was performed 1,417 times for 810 patients

Detection test by nucleic acid for organism, amplified probe technique

A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.

This service was performed 18,421 times for 810 patients

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique

A detection test for Staphylococcus aureus uses a method called the amplified probe technique. This method identifies the bacteria's unique genetic material, or nucleic acid, helping to confirm its presence. It's a highly accurate way to detect this type of bacteria.

This service was performed 1,417 times for 810 patients

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique

This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.

This service was performed 1,417 times for 810 patients

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique

A detection test by nucleic acid for Group B Strep uses an amplified probe technique. This test identifies the presence of Group B Strep bacteria in the body. It involves collecting a sample, usually a swab, which is then examined in a lab for the bacteria's genetic material.

This service was performed 1,417 times for 810 patients

Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique

This is a test to identify a common microscopic organism that can cause discomfort. The technique involves using a special probe to amplify the organism's genetic material, making it easier to detect. It's a simple, safe, and accurate procedure.

This service was performed 20 times for 17 patients

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

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.

This service was performed 613 times for 349 patients

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

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.

This service was performed 3,631 times for 810 patients

Gonadotropin, follicle stimulating (reproductive hormone) level

This is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.

This service was performed 267 times for 251 patients

Gonadotropin, luteinizing (reproductive hormone) level

This is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.

This service was performed 268 times for 252 patients

Identification of organisms by genetic analysis, amplified probe technique

This procedure involves identifying organisms like bacteria or viruses in your body. It's done by amplifying a small part of their genetic material, making it easier to detect. This technique helps in accurate diagnosis and appropriate treatment.

This service was performed 1,728 times for 125 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within

This is a test to detect the COVID-19 virus. It uses a technique that amplifies the virus's genetic material (DNA or RNA) for detection. High throughput technologies are used for rapid and large-scale testing. The procedure is completed within a set time frame.

This service was performed 14 times for 13 patients

Liver function blood test panel

A liver function blood test panel helps check the health of your liver. It measures various proteins, liver enzymes, and bilirubin in your blood. If these levels are too high or too low, it could signal a liver problem. It's a simple, non-invasive test that involves drawing blood.

This service was performed 53 times for 49 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 1,303 times for 868 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 621 times for 99 patients

Prolactin (milk producing hormone) level

A prolactin level test measures the amount of a hormone, prolactin, in your blood. This hormone plays a role in many bodily functions, such as the creation of milk. High or low levels can indicate certain health conditions. The test involves a simple blood draw.

This service was performed 274 times for 253 patients

Psa (prostate specific antigen) measurement, total

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.

This service was performed 1,197 times for 816 patients

Screening test for pathogenic organisms

A screening test for pathogenic organisms is a routine check-up procedure. It helps to identify harmful microorganisms in your body that can cause diseases. This involves collecting a sample like blood, saliva, or tissue, which is then examined in a lab for signs of these organisms.

This service was performed 2,221 times for 1,314 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 2,219 times for 1,335 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 117 times for 117 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 933 times for 687 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 23 times for 21 patients

Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method

This procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.

This service was performed 36 times for 36 patients

Testosterone (hormone) level, total

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.

This service was performed 528 times for 436 patients

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 07093 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 100, 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 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: 100 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: N/A

  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.

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