DR. JAMES RICHARD BERENSON M.D.
NPI 1124051560
Specialist - Research Study in West Hollywood, CA

Medicare Participation & PECOS Enrollment Status

James Berenson 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.

James Berenson 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: 9335133677

  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: I20040412000279

  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.

Administration of additional new drug or substance into vein using push technique

This procedure involves injecting a new medication or substance directly into your vein using a method called the 'push' technique. It's a quick way to deliver medication into your bloodstream for fast-acting relief or treatment.

This service was performed 139 times for 17 patients

Administration of additional new drug or substance into vein, 1 hour or less

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

This service was performed 127 times for 19 patients

Administration of chemotherapy into vein using push technique

Chemotherapy, a cancer treatment, can be administered directly into your vein using the push technique. This involves a healthcare professional slowly injecting the drug into your vein through a syringe. It's a quick method, usually taking only a few minutes.

This service was performed 599 times for 42 patients

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 1,175 times for 70 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 139 times for 31 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 13 times for 13 patients

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

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.

This service was performed 143 times for 16 patients

Amylase (enzyme) level

Amylase is an enzyme that helps break down starches into sugars during digestion. An amylase level test measures the amount of this enzyme in your blood or urine. This test helps identify conditions like pancreatitis or other digestive issues.

This service was performed 16 times for 12 patients

Biopsy and aspiration of bone marrow sample for diagnosis

A bone marrow biopsy and aspiration is a procedure where a small amount of bone marrow is removed for testing. It involves inserting a needle into a bone, typically the hip, to collect a sample. It can help diagnose various diseases and monitor treatment effectiveness.

This service was performed 17 times for 15 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 2,160 times for 199 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

This service was performed 70 times for 21 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 2,681 times for 198 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 102 times for 75 patients

Established patient office or other outpatient visit, 40-54 minutes

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.

This service was performed 1,344 times for 205 patients

Immunologic analysis technique on serum (immunofixation)

Immunofixation is a lab test that helps identify proteins called immunoglobulins in your blood serum. These proteins are part of your immune system. Changes in their levels can indicate certain diseases. The test is simple and only requires a blood sample.

This service was performed 235 times for 105 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 304 times for 68 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

This service was performed 1,992 times for 92 patients

Injection of drug or substance under skin or into muscle

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.

This service was performed 312 times for 49 patients

Injection, bortezomib (velcade), 0.1 mg

Bortezomib (Velcade) is a medication administered through an injection. It's used to treat multiple myeloma and mantle cell lymphoma, types of cancer. It works by blocking certain proteins in cancer cells, slowing their growth.

This service was performed 19,956 times for 42 patients

Injection, bortezomib, not otherwise specified, 0.1 mg

Bortezomib is a medication administered via injection to treat certain types of cancer, including multiple myeloma and mantle cell lymphoma. It works by slowing or stopping the growth of cancer cells in your body. The dosage is 0.1 mg.

This service was performed 8,265 times for 34 patients

Injection, carfilzomib, 1 mg

Carfilzomib is a medication given through injection to treat certain types of cancer, particularly multiple myeloma. It works by stopping or slowing the growth of cancer cells in your body. The dosage is determined by your doctor based on your medical condition.

This service was performed 22,670 times for 19 patients

Injection, denosumab, 1 mg

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.

This service was performed 16,220 times for 28 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 32,389 times for 90 patients

Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg

Doxorubicin Hydrochloride Liposomal is a chemotherapy drug injected into your vein to treat cancer. The liposomal form helps the drug target cancer cells more specifically. It works by stopping cancer cells from dividing and growing. The dosage is 10 mg.

This service was performed 327 times for 15 patients

Injection, elotuzumab, 1 mg

Elotuzumab is a medication administered via injection to treat multiple myeloma, a type of cancer affecting plasma cells. It works by helping the immune system attack cancer cells. The dosage is based on your medical condition and response to treatment.

This service was performed 141,693 times for 29 patients

Injection, epoetin alfa-epbx, biosimilar, (retacrit) (for non-esrd use), 1000 units

Epoetin alfa-epbx (Retacrit) is a biosimilar injection used for non-ESRD (End-Stage Renal Disease). It helps your body make more red blood cells, increasing your energy and well-being. It's usually given under the skin or into a vein by a healthcare professional.

This service was performed 5,080 times for 27 patients

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)

Ferumoxytol injection is a treatment for iron deficiency anemia, a condition where your body lacks enough iron. It is injected into your vein to increase iron levels, aiding in the production of healthy red blood cells. This treatment is not for ESRD patients.

This service was performed 32,130 times for 25 patients

Injection, isatuximab-irfc, 10 mg

Isatuximab-irfc is a medication given by injection to treat multiple myeloma, a type of blood cancer. It works by helping the immune system attack cancer cells. The dosage is based on your medical condition and response to treatment.

This service was performed 11,296 times for 26 patients

Injection, zoledronic acid, 1 mg

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

This service was performed 1,731 times for 70 patients

Insertion of needle into vein for collection of blood sample

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.

This service was performed 635 times for 137 patients

Lactate dehydrogenase (enzyme) level

A Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.

This service was performed 66 times for 35 patients

Manual urinalysis test with examination using microscope, automated

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

This service was performed 47 times for 24 patients

Microscopic examination for white blood cells with manual cell count

This is a lab test where a small sample of your blood is studied under a microscope. The goal is to count the number of white blood cells, which are crucial for your body's immune response. The count can help identify potential health issues.

This service was performed 71 times for 21 patients

New patient office or other outpatient visit, 60-74 minutes

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.

This service was performed 30 times for 30 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 223 times for 58 patients

Phosphate level

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

This service was performed 661 times for 69 patients

Protein measurement, serum

A serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.

This service was performed 1,652 times for 196 patients

Unclassified drugs

Unclassified drugs are medications that don't fit into an existing category or class due to their unique properties or uses. They may be used for various conditions and their effects may differ widely. Always ask your healthcare provider for more information about these drugs.

This service was performed 745 times for 42 patients

Uric acid level, blood

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

This service was performed 146 times for 52 patients

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 90.53, 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 provider also has detailed performance information the following quality measures: .

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: 90.53 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: 71.07

  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: N/A

  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.

MIPS Quality Measures

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number

05D1031557

Facility Type

Physician Office

Certificate Effective Date

June 16, 2025

Certificate Expiration Date

June 15, 2027

Laboratory Director

JAMES BERENSON

Certificate Type

Certificate of Accreditation

Certificate Type Description

This is a CLIA certificate is issued to James Berenson on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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