SHAHINAZ SOLIMAN MD
NPI 1225069545
Family Medicine in Torrance, CA

Medicare Participation & PECOS Enrollment Status

Shahinaz Soliman 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.

Shahinaz Soliman 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: 749173367

  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: I20040205001308

  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)

  7 DME suppliers used 14 Medicare Claims 54 Services Paid

• DME-Other DME (DE001N)

  Continuous positive airway pressure (cpap) device (HCPCS:E0601)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Other DME (DE017N)

  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

  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.

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 49 times for 47 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 112 times for 112 patients

Blood glucose (sugar) test performed by hand-held instrument

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

This service was performed 49 times for 27 patients

Complete ultrasound of abdomen and pelvis artery and vein blood flow

This procedure uses sound waves to create images of your abdomen and pelvis, specifically focusing on the arteries and veins. It helps in assessing the blood flow and detecting any abnormalities, ensuring your overall well-being.

This service was performed 193 times for 159 patients

Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.

This service was performed 11 times for 11 patients

Complete ultrasound of within the brain blood flow

A complete ultrasound of brain blood flow, also known as a Transcranial Doppler, is a non-invasive procedure that uses sound waves to measure the speed and direction of blood flow in the brain. This helps detect any abnormalities or blockages.

This service was performed 121 times for 121 patients

Complete ultrasound scan behind abdominal cavity

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

This service was performed 240 times for 178 patients

Complete ultrasound scan of abdomen

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

This service was performed 186 times for 155 patients

Complete ultrasound scan of pelvis

A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.

This service was performed 33 times for 30 patients

Complete ultrasound study of arm and leg arteries

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

This service was performed 51 times for 49 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

This service was performed 210 times for 40 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

This service was performed 138 times for 40 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 61 times for 61 patients

Diabetes outpatient self-management training services, individual, per 30 minutes

This service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.

This service was performed 48 times for 25 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 96 times for 67 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 1,000 times for 244 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 54 times for 47 patients

Exam of neurobehavioral status, first hour

An exam of neurobehavioral status is a medical procedure that evaluates your brain's functions. This includes assessing your cognitive abilities, emotional responses, and behavioral patterns. The first hour of the exam is typically dedicated to this initial evaluation.

This service was performed 80 times for 80 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 48 times for 46 patients

Insertion of needle into vein (3 years or older)

This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.

This service was performed 56 times for 55 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 205 times for 130 patients

Limited ultrasound scan behind abdominal cavity

A limited ultrasound scan behind the abdominal cavity is a non-invasive imaging method that helps visualize structures in the back of your abdomen. This procedure uses sound waves to create pictures of these areas, assisting in diagnosing certain conditions.

This service was performed 258 times for 181 patients

Limited ultrasound scan of abdomen

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

This service was performed 212 times for 153 patients

Limited ultrasound scan of pelvis

A limited ultrasound scan of the pelvis is a non-invasive imaging test. It uses high-frequency sound waves to create pictures of the lower abdomen area. This helps doctors view and assess the health of certain internal structures. It's painless and usually takes about 30 minutes.

This service was performed 132 times for 118 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

This service was performed 106 times for 21 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

This service was performed 95 times for 22 patients

Measurement of liver stiffness

Measurement of liver stiffness is a non-invasive procedure that helps assess the health of your liver. It uses sound waves to detect the hardness of the liver tissue, which can indicate conditions like fibrosis or cirrhosis. It's a simple, painless test that provides valuable information about your liver's health.

This service was performed 12 times for 12 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 32 times for 32 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This 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 185 times for 117 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

This service was performed 25 times for 25 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

This service was performed 117 times for 25 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 158 times for 139 patients

Stool analysis for blood to screen for colon tumors

A stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.

This service was performed 15 times for 15 patients

Telephone medical discussion with physician, 5-10 minutes

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

This service was performed 26 times for 22 patients

Test for hearing various pitches using earphone and device placed against the bone

This is a hearing test that checks your ability to hear different pitches or frequencies. It involves wearing earphones and placing a device against your bone, usually behind the ear. It helps identify any hearing issues you might have.

This service was performed 64 times for 64 patients

Ultrasound measurement of bladder capacity after voiding

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

This service was performed 43 times for 43 patients

Ultrasound of abdomen and pelvis artery and vein blood flow

An ultrasound of your abdomen and pelvis arteries and veins is a non-invasive procedure that uses sound waves to create images of your blood vessels. This helps in assessing the flow of blood, identifying blockages, or detecting other abnormalities. It's a safe, painless process.

This service was performed 47 times for 46 patients

Ultrasound of aorta, vena cava, groin vessels or bypass grafts

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps doctors check for issues like blockages or enlargements. It's non-invasive and painless.

This service was performed 11 times for 11 patients

Ultrasound of arm arteries or artery grafts

An ultrasound of arm arteries or artery grafts involves using sound waves to create images of your arm's blood vessels. This helps evaluate blood flow and detect issues like blockages or narrowing. It's non-invasive, painless, and safe.

This service was performed 50 times for 49 patients

Ultrasound of both sides of head and neck blood flow

An 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 189 times for 180 patients

Ultrasound of leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

This service was performed 69 times for 67 patients

Ultrasound of one leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive test using sound waves to create images of your blood vessels. This helps doctors assess blood flow, identify blockages, and monitor the health of grafts.

This service was performed 46 times for 45 patients

Ultrasound scan of abdominal aorta

An ultrasound scan of the abdominal aorta is a non-invasive imaging test. It uses sound waves to create pictures of the main blood vessel in your abdomen, the aorta, to check its size and shape. This helps detect any abnormalities or issues early.

This service was performed 56 times for 56 patients

Ultrasound scan of growth for measuring elasticity, each additional growth

An ultrasound scan of additional growths measures their elasticity. This helps determine the nature of the growth. The process involves using sound waves to create images of the growths. It's non-invasive and typically painless, providing valuable information for your health.

This service was performed 229 times for 147 patients

Ultrasound scan of growth for measuring elasticity, first growth

An ultrasound scan of a growth measures its elasticity, which helps understand its nature. For the first growth, a probe glides on the skin over the area of interest, emitting sound waves that create images of the growth. This is non-invasive and painless.

This service was performed 241 times for 177 patients

Ultrasound scan of head and neck soft tissue

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

This service was performed 191 times for 144 patients

Ultrasound scan of organ tissue for measuring elasticity

An ultrasound scan of organ tissue measures elasticity, or flexibility. This non-invasive procedure uses sound waves to create images of the inside of your body. It helps in assessing the health of various organs by detecting changes in their stiffness or softness.

This service was performed 308 times for 198 patients

Ultrasound scan of prostate through rectum

An ultrasound scan of the prostate through the rectum, also known as a transrectal ultrasound, is a procedure where a small probe is gently inserted into the rectum. This probe produces sound waves to create images of the prostate gland, which helps doctors assess its size and condition.

This service was performed 34 times for 29 patients

Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina

An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.

This service was performed 31 times for 28 patients

Ultrasound study of arm and leg arteries

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

This service was performed 47 times for 46 patients

Ultrasound study of arm or leg veins with compression and maneuvers

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

This service was performed 35 times for 35 patients

Ultrasound study of one arm or leg veins with compression and maneuvers

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

This service was performed 15 times for 15 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 30 times for 22 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.09 for a new patient copayment and $27.49 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 90505 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.

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 76.03, 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.

• Final Score: 76.03 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: 61.7

  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 compromises 40% providers final MPIS scores.
  
  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: 82

  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 compromises 25% providers final MPIS scores.
  
  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 compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: 73.41

  The Cost performance category asses 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 compromises 20% of providers final MPIS scores.

• Cost Score: 73.41

  The Cost performance category asses 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 compromises 20% of providers final MPIS scores.

MIPS Quality Measures

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