SHOBA MENON MD
NPI 1154481539
Internal Medicine in Wading River, NY

Medicare Participation & PECOS Enrollment Status

Shoba Menon 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.

Shoba Menon 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: 6800944315

  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: I20090511000063

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  11 DME suppliers used 28 Medicare Claims 70 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  7 DME suppliers used 20 Medicare Claims 29 Services Paid

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.

Acute hepatitis panel

An acute hepatitis panel is a set of blood tests that checks for specific markers in your blood that indicate a recent infection with a type of hepatitis virus. It helps determine which type of hepatitis you may have to guide appropriate treatment.

This service was performed 15 times for 13 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 153 times for 151 patients

Annual depression screening, 15 minutes

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

This service was performed 16 times for 16 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 75 times for 75 patients

Assessment of and care planning for impaired thought processing, typically 50 minutes

This service involves a thorough evaluation of your thought processes, which may be impacting your daily life. In a typical 50-minute session, a healthcare professional will assess your cognitive abilities, identify any areas of concern, and develop a personalized care plan to help improve your mental function.

This service was performed 20 times for 20 patients

Blood potassium level

A blood potassium level test measures the amount of potassium in your blood. Potassium is a vital mineral for the body, helping nerves and muscles, especially the heart, to function properly. Abnormal levels can cause health issues like irregular heartbeat, muscle weakness, or numbness.

This service was performed 39 times for 31 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 36 times for 33 patients

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 62 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 707 times for 373 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 141 times for 141 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 710 times for 362 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 370 times for 78 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 745 times for 374 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

This service was performed 25 times for 25 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 646 times for 321 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 20 times for 20 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 13 times for 12 patients

Detection test by nucleic acid for multiple organisms, amplified probe(s) technique

This is a test that identifies various microorganisms in your body using a method called amplified probe technique. It targets specific genetic material (nucleic acids) of the organisms, amplifying them for easy detection. This helps in diagnosing infections accurately.

This service was performed 96 times for 29 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 416 times for 29 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 32 times for 29 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 32 times for 29 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 32 times for 29 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 32 times for 29 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 76 times for 29 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 582 times for 283 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 578 times for 281 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 71 times for 58 patients

Ferritin (blood protein) level

A Ferritin level test measures the amount of ferritin, a protein that stores iron, in your blood. It helps determine how much iron your body is storing. If levels are low, it may indicate iron deficiency, while high levels could signify conditions like iron overload.

This service was performed 13 times for 12 patients

Folic acid level, serum

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

This service was performed 646 times for 322 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 655 times for 347 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 49 times for 47 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, making use of high throughput technologies as described by cms-2020-01-r

This is a test for COVID-19. It uses high-tech methods to find the virus's genetic material in your body. The amplified probe technique helps detect the virus even in small amounts. This is crucial for early detection and effective treatment.

This service was performed 52 times for 48 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 93 times for 92 patients

Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free

The quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.

This service was performed 22 times for 22 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 36 times for 36 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 48 times for 19 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 47 times for 18 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 970 times for 421 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 26 times for 19 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 656 times for 326 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 15 times for 15 patients

Parathormone (parathyroid hormone) level

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

This service was performed 22 times for 13 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 75 times for 69 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 13 times for 12 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 62 times for 59 patients

Thyroxine (thyroid chemical), total

A Thyroxine (thyroid chemical) total test measures the amount of thyroxine, a hormone produced by your thyroid gland, in your blood. This hormone helps regulate your body's metabolism. The test can help diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism.

This service was performed 17 times for 15 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 606 times for 317 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 108 times for 73 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 608 times for 317 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 11792 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Shoba Menon is affiliated with the following medical facilities:

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Frequently Asked Questions