JAY B PENAFIEL MD
NPI 1174515217
Internal Medicine - Cardiovascular Disease in Glen Burnie, MD
About Jay B Penafiel Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAY B PENAFIEL MD (NPI 1174515217) is an individual cardiovascular disease provider in Glen Burnie, Maryland, licensed in Maryland (D50087) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with University Of Md Baltimore Washington Medical Center, and is a graduate of University Of Maryland School Of Medicine (1994).
NPPES Registry Identity
Specialties & Licenses
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jay B Penafiel Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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 (DE013N)
Automatic external defibrillator, with integrated electrocardiogram analysis, garment type (HCPCS:K0606)
1 DME suppliers used 11 Medicare Claims 11 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.
Blood test, clotting time
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional
Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Injection, aminophyllin, up to 250 mg
Injection, regadenoson, 0.1 mg
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Nuclear medicine study of heart pumping function by labeling red blood cells with measurement of internal blood volume ejected with every beat over multiple cycles
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
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 521 times for 49 patientsAn Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. In a 2-day continuous ECG, sensors attached to your chest monitor your heart's rhythm over 48 hours. A healthcare professional then reviews the data to identify any irregularities.
This service was performed 13 times for 13 patientsAn Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.
This service was performed 15 times for 15 patientsThis 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 56 times for 54 patientsThis 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 810 times for 503 patientsAn exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
This service was performed 926 times for 922 patientsAn aminophyllin injection is a treatment often used for severe asthma or other lung conditions. It helps to relax and open air passages in the lungs, making it easier to breathe. Up to 250 mg can be administered in one dose.
This service was performed 195 times for 194 patientsRegadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
This service was performed 3,290 times for 819 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 92 times for 92 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 923 times for 919 patientsThis procedure, known as a nuclear medicine study, examines your heart's function. It involves marking red blood cells and measuring the volume of blood your heart pumps with each beat. It's a safe, non-invasive way to assess how well your heart is working.
This service was performed 21 times for 21 patientsThis 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 207 times for 44 patientsAn 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 498 times for 437 patientsTechnetium Tc-99m is a radioactive tracer used in medical imaging. In this procedure, red blood cells are labeled with this tracer, then reintroduced to your body. The tracer allows doctors to track blood flow and detect abnormalities, like aneurysms or tumors.
This service was performed 21 times for 21 patientsTechnetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.
This service was performed 950 times for 924 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 97 times for 96 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 176 times for 173 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.76 for a new patient copayment and $18.86 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 21061 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $139.05
- Minimum New Patient Price $60.73
- Maximum New Patient Price $183.44
- Average New Patient Copayment $34.76
- Minimum New Patient Copayment $15.18
- Maximum New Patient Copayment $45.86
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.47
- Minimum Established Patient Price $19.6
- Maximum Established Patient Price $149.17
- Average Established Patient Copayment $18.86
- Minimum Established Patient Copayment $4.9
- Maximum Established Patient Copayment $37.29
* 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.
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 62.51, 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.
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Final Score: 62.51 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.
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Quality Score: 39.79
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.
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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 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: 55.32
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.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 0% | 311 |
| Controlling High Blood Pressure | 81% | 648 |
| Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) | 98% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 213 |
| Documentation of Current Medications in the Medical Record | 20% | 2034 |
| Falls: Screening for Future Fall Risk | 8% | 797 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 17% | 1272 |
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. Jay Penafiel is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UNIVERSITY OF MD BALTIMORE WASHINGTON MEDICAL CENTER | 301 HOSPITAL DRIVE GLEN BURNIE, MD 21061 | (410) 595-1967 | Acute Care Hospitals |
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
GLEN BURNIE, MD 21061
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174515217, enumerated as an "individual" on August 16, 2005.
The provider is located at 1417 MADISON PARK DR GLEN BURNIE, MD 21061 and the phone number is (410) 768-6600.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Medicare, Medicaid and Railroad Medicare. Please consult your insurance carrier or call the provider to verify.
Jay Penafiel is affiliated with: UNIVERSITY OF MD BALTIMORE WASHINGTON MEDICAL CENTER.
