DR. MATTHEW JOHN DENEFE MD
NPI 1174084214
Emergency Medicine in Little Rock, AR
About Dr. Matthew John Denefe Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MATTHEW JOHN DENEFE MD (NPI 1174084214) is an individual emergency medicine provider in Little Rock, Arkansas, licensed in Arkansas (E-14283) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and is a graduate of University Of Arkansas College Of Medicine (2019).
NPPES Registry Identity
Specialties & Licenses 2
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Accepted Insurance
Medicare Participation & PECOS Enrollment Status
Matthew Denefe 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.
Matthew Denefe 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: 7416281076
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: I20220509001035
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.
Critical care, first 30-74 minutes
Emergency department visit with high level of medical decision making
Emergency department visit with low level of medical decision making
Emergency department visit with moderate level of medical decision making
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 29 times for 29 patientsAn emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 160 times for 156 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 32 times for 31 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 108 times for 105 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $19.93 for a new patient copayment and $22.9 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 72205 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $79.72
- Minimum New Patient Price $51.36
- Maximum New Patient Price $157.74
- Average New Patient Copayment $19.93
- Minimum New Patient Copayment $12.84
- Maximum New Patient Copayment $39.43
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $91.63
- Minimum Established Patient Price $16.16
- Maximum Established Patient Price $128.77
- Average Established Patient Copayment $22.9
- Minimum Established Patient Copayment $4.04
- Maximum Established Patient Copayment $32.19
* 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.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174084214, enumerated as an "individual" on March 29, 2019.
The provider is located at 4301 W MARKHAM ST # 584 LITTLE ROCK, AR 72205 and the phone number is (501) 686-6996.
Emergency Medicine with taxonomy code 207P00000X.
The provider might be accepting Accepts: Arkansas Blue Cross and Blue Shield, Health. Please consult your insurance carrier or call the provider to verify.
