PAUL MALLER MD
NPI 1144317025
Internal Medicine in Floral Park, NY

Medicare Participation & PECOS Enrollment Status

Paul Maller 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.

Paul Maller 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: 749203487

  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: I20060109001089

  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.

Albumin (protein) level

The Albumin Level test measures the amount of albumin, a vital protein made by the liver, in your blood. This protein helps keep fluid in your bloodstream so it doesn't leak into other tissues. It's also vital for tissue growth and healing. Low or high levels can indicate certain health issues.

This service was performed 112 times for 35 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 112 times for 35 patients

Bilirubin level, total

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.

This service was performed 111 times for 35 patients

Blood creatinine level

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

This service was performed 112 times for 35 patients

Blood glucose (sugar) level

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

This service was performed 76 times for 33 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 109 times for 35 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 102 times for 35 patients

Calcium level, total

A total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.

This service was performed 112 times for 35 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 113 times for 35 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 153 times for 34 patients

Glutamyltransferase (liver enzyme) level

Glutamyltransferase (GGT) level is a blood test that helps check your liver's health. High GGT levels may indicate liver disease or damage. The test involves a simple blood draw and results help your doctor understand your liver's condition better.

This service was performed 78 times for 33 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 114 times for 36 patients

Liver enzyme (sgot), level

A Liver Enzyme (SGOT) Level test is a simple blood test used to measure the amount of certain enzymes in your blood. These enzymes are normally found in liver cells. If the liver is damaged or diseased, these enzymes can leak into your bloodstream, indicating potential liver issues.

This service was performed 111 times for 35 patients

Liver enzyme (sgpt), level

A liver enzyme (SGPT) level test is a blood test that checks the health of your liver. SGPT is an enzyme found in your liver cells. If your liver is damaged or inflamed, SGPT can leak into your bloodstream, raising the enzyme level. This test helps identify liver diseases early.

This service was performed 111 times for 35 patients

Measurement c-reactive protein for detection of infection or inflammation

C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.

This service was performed 111 times for 35 patients

Phosphatase (enzyme) level, alkaline

The Alkaline Phosphatase Level test measures the amount of alkaline phosphatase, an enzyme, in your blood. High or low levels can indicate a variety of health conditions, such as liver disease or bone disorders. It's a common test done to help diagnose and monitor these conditions.

This service was performed 111 times for 35 patients

Red blood cell sedimentation rate, to detect inflammation, non-automated

The Red Blood Cell Sedimentation Rate test measures how quickly red blood cells settle at the bottom of a test tube. If they settle faster than normal, it may indicate inflammation in the body. This test is non-automated, meaning it's manually performed by a lab technician.

This service was performed 111 times for 35 patients

Rheumatoid factor analysis

Rheumatoid factor analysis is a blood test utilized to help diagnose rheumatoid arthritis, an autoimmune disorder causing joint inflammation. It detects the presence of rheumatoid factor, an antibody often found in those with the condition.

This service was performed 109 times for 35 patients

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

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.

This service was performed 14 times for 13 patients

Test for detection of infectious agent antibody, qualitative or semiquantitative

This test helps identify if your body has produced antibodies, which are proteins that fight off infections. It is either qualitative (yes/no result) or semiquantitative (measures the amount of antibodies). This can help diagnose certain infectious diseases.

This service was performed 112 times for 35 patients

Thyroid hormone, t3 measurement, total

The T3 Total Test measures the amount of thyroid hormone T3 in your blood. This hormone, produced by the thyroid gland, is crucial for body's metabolism and energy production. Abnormal levels may indicate a thyroid disorder.

This service was performed 110 times for 35 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 109 times for 35 patients

Total protein level, blood

A total protein level blood test measures the amount of proteins in your blood. Proteins are essential for body functions, including immune response, tissue repair, and nutrient transportation. Abnormal levels may indicate certain diseases or conditions. It's a simple test involving a blood draw.

This service was performed 111 times for 35 patients

Urea nitrogen level to assess kidney function, quantitative

The urea nitrogen level test is a routine blood test that checks the amount of urea nitrogen in your blood to evaluate how well your kidneys are working. If the levels are higher than normal, it may indicate that your kidneys are not functioning properly.

This service was performed 111 times for 35 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 112 times for 35 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $38.57 for a new patient copayment and $29.4 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 11001 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.

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

33D0142626

Facility Type

Physician Office

Certificate Effective Date

August 29, 2024

Certificate Expiration Date

August 28, 2026

Laboratory Director

DR. PAUL MALLER

Certificate Type

Certificate of Compliance

Certificate Type Description

This CLIA certificate is issued to Paul Maller after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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