STEPHANIE LISETTE BEDOLLA NP-C
NPI 1265717565
Nurse Practitioner - Adult Health in Petaluma, CA

Medicare Participation & PECOS Enrollment Status

Stephanie Bedolla 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.

Stephanie Bedolla 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: 2466613153

  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: I20160404002223

  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 (DE001N)

  Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

  24 DME suppliers used 542 Medicare Claims 543 Services Paid

• DME-Other DME (DE000N)

  Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

  4 DME suppliers used 11 Medicare Claims 16 Services Paid

• DME-Other DME (DE001N)

  Full face mask used with positive airway pressure device, each (HCPCS:A7030)

  18 DME suppliers used 272 Medicare Claims 272 Services Paid

• DME-Other DME (DE001N)

  Face mask interface, replacement for full face mask, each (HCPCS:A7031)

  16 DME suppliers used 264 Medicare Claims 699 Services Paid

• DME-Other DME (DE001N)

  Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

  17 DME suppliers used 283 Medicare Claims 1567 Services Paid

• DME-Other DME (DE001N)

  Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)

  17 DME suppliers used 186 Medicare Claims 1017 Services Paid

• DME-Other DME (DE001N)

  Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

  21 DME suppliers used 498 Medicare Claims 500 Services Paid

• DME-Other DME (DE001N)

  Headgear used with positive airway pressure device (HCPCS:A7035)

  24 DME suppliers used 447 Medicare Claims 447 Services Paid

• DME-Other DME (DE001N)

  Chinstrap used with positive airway pressure device (HCPCS:A7036)

  10 DME suppliers used 19 Medicare Claims 19 Services Paid

• DME-Other DME (DE001N)

  Tubing used with positive airway pressure device (HCPCS:A7037)

  13 DME suppliers used 170 Medicare Claims 170 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  28 DME suppliers used 766 Medicare Claims 4331 Services Paid

• DME-Other DME (DE001N)

  Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

  17 DME suppliers used 261 Medicare Claims 262 Services Paid

• DME-Other DME (DE001N)

  Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

  20 DME suppliers used 315 Medicare Claims 316 Services Paid

• DME-Other DME (DE005N)

  Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

  2 DME suppliers used 63 Medicare Claims 63 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)

  9 DME suppliers used 129 Medicare Claims 129 Services Paid

• DME-Other DME (DE001N)

  Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0471)

  6 DME suppliers used 80 Medicare Claims 81 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  10 DME suppliers used 57 Medicare Claims 57 Services Paid

• DME-Other DME (DE001N)

  Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)

  2 DME suppliers used 165 Medicare Claims 168 Services Paid

• DME-Other DME (DE000N)

  Nebulizer, with compressor (HCPCS:E0570)

  4 DME suppliers used 54 Medicare Claims 54 Services Paid

• DME-Other DME (DE001N)

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

  14 DME suppliers used 542 Medicare Claims 544 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)

  10 DME suppliers used 266 Medicare Claims 266 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Portable oxygen concentrator, rental (HCPCS:E1392)

  4 DME suppliers used 95 Medicare Claims 95 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

  2 DME suppliers used 27 Medicare Claims 27 Services Paid

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

  18 DME suppliers used 42 Medicare Claims 42 Services Paid

Drugs Administered Through DME

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

  11 DME suppliers used 21 Medicare Claims 4770 Services Paid

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

  7 DME suppliers used 23 Medicare Claims 2160 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.

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 76 times for 76 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 14 times for 13 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

This service was performed 61 times for 24 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 79 times for 36 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more

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 13 times for 12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

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 54 times for 43 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

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 130 times for 92 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 29 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 1,140 times for 19 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

This service was performed 23 times for 20 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

This service was performed 17 times for 14 patients

Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes

An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.

This service was performed 14 times for 11 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

This service was performed 25 times for 25 patients

Telephone medical discussion provided by nonphysician professional, 11-20 minutes

This service involves a nonphysician professional, like a nurse or therapist, discussing your health concerns over the phone for 11-20 minutes. It's a convenient way to address questions or issues without needing to visit the clinic.

This service was performed 21 times for 18 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.04 for a new patient copayment and $27.47 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 94954 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.

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