MARK S POTENZA MD
NPI 1134122096
Surgery - Plastic and Reconstructive Surgery in Camillus, NY

Medicare Participation & PECOS Enrollment Status

Mark Potenza 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.

Mark Potenza 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: 2264482876

  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: I20060313000513

  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.

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm

This procedure involves repairing a wound on your eyelids, nose, ears, or lip that is between 2.6 and 7.5 cm long. It's considered complicated due to the location and size. The doctor will clean, treat, and stitch the wound to promote healing.

This service was performed 15 times for 14 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

This service was performed 20 times for 20 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

This service was performed 35 times for 33 patients

Complicated repair of wound of trunk, 2.6-7.5 cm

This service involves the intricate repair of a wound on your body's main structure, between your neck and limbs. The wound measures 2.6-7.5 cm. The procedure includes deep-layer stitching and may involve repairing damaged tissue.

This service was performed 11 times for 11 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm

This procedure involves the removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 2.1-3.0 cm in size. The goal is to eliminate the cancer and reduce the risk of it spreading.

This service was performed 33 times for 27 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm

This procedure involves the removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth, measuring between 3.1-4.0 cm. The process may involve surgery, laser, or other methods to destroy the growth, aiding in cancer treatment.

This service was performed 20 times for 18 patients

Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm

This procedure involves removing a cancerous growth on the scalp, neck, hands, or feet that measures between 2.1-3.0 cm. It's done using various techniques like surgery, laser, or freezing, aiming to eliminate all cancer cells while preserving healthy tissue.

This service was performed 17 times for 11 patients

Destruction of cancer skin growth of trunk, arms, or legs, 3.1-4.0 cm

This involves removing a cancerous skin growth on the trunk, arms, or legs that measures 3.1-4.0 cm. The procedure may use methods like surgery, lasers, or radiation to destroy the growth, helping to prevent cancer from spreading.

This service was performed 14 times for 12 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 639 times for 568 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 429 times for 361 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm

This procedure involves repairing a wound on the face, ears, eyelids, nose, lips, or mouth that measures between 2.6-5.0 cm. The process includes cleaning, suturing if necessary, and dressing the wound to promote healing and prevent infection.

This service was performed 73 times for 65 patients

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm

This is a procedure to mend a moderate wound between 2.6-7.5 cm on your neck, hands, or feet. It involves cleaning the wound, removing any damaged tissue, and stitching it back together to promote healing and minimize scarring.

This service was performed 20 times for 20 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

This service was performed 78 times for 69 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 894 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 107 times for 107 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

This service was performed 58 times for 47 patients

Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm

This procedure involves the removal of a cancerous skin growth, between 2.1 and 3.0 cm, from the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The goal is to eliminate all cancer cells while minimizing scarring.

This service was performed 31 times for 29 patients

Removal of cancer skin growth of body, arms, or legs, 3.1-4.0 cm

This procedure involves removing a cancerous skin growth measuring 3.1-4.0 cm on the body, arms, or legs. The area is numbed, then the growth is carefully cut out. The wound is stitched for healing. Regular follow-ups ensure complete removal and recovery.

This service was performed 38 times for 37 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves the careful removal of a small cancerous growth on the face, ears, eyelids, nose, lips, or mouth. It's a precise operation performed by a specialist to ensure complete removal of the cancer while preserving healthy tissue.

This service was performed 27 times for 25 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

This procedure involves the surgical removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 1.1-2.0 cm in size. This is done to prevent the cancer from spreading and to restore health.

This service was performed 88 times for 68 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm

This procedure involves the careful removal of a cancerous growth on the face, ears, eyelids, nose, lips, or mouth that measures between 2.1 to 3.0 cm. The goal is to eliminate the cancer while preserving surrounding healthy tissue.

This service was performed 55 times for 50 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm

This procedure involves the careful removal of a cancerous growth on the face, including areas like the ears, eyelids, nose, lips, or mouth. The size of the growth is between 3.1 and 4.0 cm. The aim is to eliminate cancer cells while preserving surrounding healthy tissue.

This service was performed 19 times for 18 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

This procedure involves the careful removal of a cancerous skin growth measuring between 1.1 to 2.0 cm, located on the scalp, neck, hands, or feet. The goal is to eliminate the cancer and prevent its spread. This is done under local anesthesia to minimize discomfort.

This service was performed 44 times for 34 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 2.1-3.0 cm

This procedure involves removing a cancerous growth on the scalp, neck, hands, or feet that measures between 2.1 and 3.0 cm. The process includes numbing the area, excising the growth, and then stitching the wound for healing. The aim is to eliminate cancer cells and prevent spread.

This service was performed 25 times for 24 patients

Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on your body, arms, or legs. The growth is between 0.6-1.0 cm in size. It's typically a simple process where the growth is cut away and the area is then stitched up for healing.

This service was performed 42 times for 32 patients

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth on the body, arms, or legs that is between 1.1 and 2.0 cm in size. It's a safe and routine procedure performed by a medical professional to improve your skin health and appearance.

This service was performed 53 times for 40 patients

Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm

This is a procedure where a noncancerous skin growth, sized 2.1-3.0 cm, on the body, arms, or legs is removed. It's typically done under local anesthesia. The process involves cutting out the growth and stitching the skin back together. The aim is to eliminate discomfort and prevent potential health issues.

This service was performed 14 times for 11 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less

This procedure involves the removal of a noncancerous skin growth on the face, ears, eyelids, nose, lips, or mouth that is 0.5 cm or less in size. It is a safe, routine treatment that helps maintain skin health and appearance.

This service was performed 24 times for 22 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on areas of the face such as the nose, lips, mouth, ears, or eyelids. The growth size is between 0.6-1.0 cm. The goal is to improve comfort, function, or appearance.

This service was performed 64 times for 49 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth on your face, ears, eyelids, nose, lips, or mouth that measures between 1.1-2.0 cm. It's a safe process to enhance your comfort and appearance.

This service was performed 96 times for 75 patients

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on areas like the scalp, neck, hands, or feet. The size of the growth is between 0.6-1.0 cm. The process is performed by a medical professional and helps maintain skin health.

This service was performed 19 times for 17 patients

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth in areas such as the scalp, neck, hands, or feet. The growth being removed is between 1.1 to 2.0 cm in size. The process is safe, typically involves local anesthesia, and is performed by a healthcare professional.

This service was performed 44 times for 34 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

This service was performed 62 times for 36 patients

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.

This service was performed 242 times for 128 patients

Shaving of skin growth of body, arms, or legs, more than 2.0 cm

This procedure involves the removal of a skin growth on your body, arms, or legs that is over 2.0 cm. A special tool is used to shave off the growth, often under local anesthesia. It's a routine, safe process to maintain skin health.

This service was performed 22 times for 14 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.5 cm or less

This procedure involves the careful removal of a small skin growth on the face or related areas. A medical professional uses a special tool to gently shave off the growth, which is 0.5 cm or less. It's a common, safe procedure.

This service was performed 38 times for 27 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

This service was performed 174 times for 112 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

This procedure involves the careful removal of a skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth being treated is between 1.1 and 2.0 cm in size. The process is typically quick, with minimal discomfort, and aids in maintaining skin health.

This service was performed 333 times for 179 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, more than 2.0 cm

This procedure involves the careful removal of a skin growth on the face, ears, eyelids, nose, lips, or mouth that is larger than 2.0 cm. The process, known as shaving, is done under local anesthesia to ensure comfort. It's a common, safe procedure.

This service was performed 15 times for 15 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

This procedure involves the careful removal of a small skin growth, between 0.6-1.0 cm in size, from the scalp, neck, hands, or feet. It's done using a special tool to gently shave off the growth, ensuring minimal discomfort.

This service was performed 36 times for 25 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

This procedure involves the careful removal of a skin growth between 1.1 to 2.0 cm in size. The growth could be located on the scalp, neck, hands, or feet. The process is done using a sharp instrument to shave off the growth, promoting healthier skin.

This service was performed 176 times for 84 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, more than 2.0 cm

This procedure involves the careful removal of a skin growth larger than 2.0 cm, located on the scalp, neck, hands, or feet. The area is first numbed, then the growth is gently shaved off. This is a safe, routine process to ensure skin health.

This service was performed 12 times for 12 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 99.75, 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: 99.75 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: 100

  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 comprises 40% of a provider's final MIPS score.
  
  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: 99

  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 comprises 25% of a provider's final MIPS score.
  
  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 comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: 100

  The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.

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