MICHAEL BRANDON WILLIAMS M.D.
NPI 1295058394
Urology in Virginia Beach, VA

Medicare Participation & PECOS Enrollment Status

Michael Williams 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.

Michael Williams 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: 3678697406

  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: I20111012000763

  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.

Orthotic Devices

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

  4 DME suppliers used 16 Medicare Claims 4590 Services Paid

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)

  5 DME suppliers used 45 Medicare Claims 9370 Services Paid

• DME-Orthotic Devices (DF000N)

  Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)

  15 DME suppliers used 144 Medicare Claims 405 Services Paid

• DME-Orthotic Devices (DF000N)

  Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each (HCPCS:A4358)

  6 DME suppliers used 12 Medicare Claims 40 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier; solid, 4 x 4 or equivalent; each (HCPCS:A4362)

  5 DME suppliers used 27 Medicare Claims 940 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy belt, each (HCPCS:A4367)

  8 DME suppliers used 62 Medicare Claims 89 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)

  11 DME suppliers used 125 Medicare Claims 3380 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each (HCPCS:A4393)

  2 DME suppliers used 15 Medicare Claims 470 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)

  5 DME suppliers used 53 Medicare Claims 1080 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, pectin-based, paste, per ounce (HCPCS:A4406)

  4 DME suppliers used 25 Medicare Claims 82 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)

  6 DME suppliers used 72 Medicare Claims 1775 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4409)

  8 DME suppliers used 71 Medicare Claims 1695 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each (HCPCS:A4419)

  1 DME suppliers used 12 Medicare Claims 720 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each (HCPCS:A4430)

  4 DME suppliers used 43 Medicare Claims 1190 Services Paid

• DME-Orthotic Devices (DF010N)

  Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each (HCPCS:A4432)

  11 DME suppliers used 130 Medicare Claims 3220 Services Paid

• DME-Orthotic Devices (DF010N)

  Skin barrier, wipes or swabs, each (HCPCS:A5120)

  9 DME suppliers used 65 Medicare Claims 2735 Services Paid

Durable Medical Equipment

• DME-Medical/Surgical Supplies (DA000N)

  Tape, waterproof, per 18 square inches (HCPCS:A4452)

  2 DME suppliers used 12 Medicare Claims 488 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive remover or solvent (for tape, cement or other adhesive), per ounce (HCPCS:A4455)

  3 DME suppliers used 11 Medicare Claims 76 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Adhesive remover, wipes, any type, each (HCPCS:A4456)

  11 DME suppliers used 58 Medicare Claims 3950 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 hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

This service was performed 140 times for 108 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 1,161 times for 600 patients

Bacterial colony count, urine

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

This service was performed 100 times for 73 patients

Bacterial urine culture

A bacterial urine culture is a laboratory test that checks for bacteria in your urine. It helps identify the type of bacteria causing an infection, enabling the selection of the most effective treatment. The test involves collecting a urine sample in a sterile container.

This service was performed 64 times for 48 patients

Bcg live intravesical instillation, 1 mg

BCG live intravesical instillation is a procedure where a weakened form of a bacteria is introduced into your bladder. This helps your body's immune system to fight off certain bladder conditions. The procedure is generally safe and effective.

This service was performed 12,000 times for 84 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 662 times for 103 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm

This procedure involves using a special instrument, an endoscope, to view and treat a small growth in the bladder and urethra. It's a minimally invasive method to remove or destroy growths measuring 0.5-2.0 cm, aiding in better urinary health.

This service was performed 38 times for 32 patients

Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm

This procedure involves using a thin, flexible tool called an endoscope to examine and remove a growth in your bladder and urethra. The growth size ranges from 2.0-5.0 cm. This is done to ensure your urinary system functions properly.

This service was performed 58 times for 48 patients

Destruction and/or removal of large growth of bladder using an endoscope

This procedure involves using a special instrument, an endoscope, to view and treat a large growth in the bladder. The growth is either destroyed or removed to alleviate symptoms and prevent further complications. It's a minimally invasive technique, enhancing recovery.

This service was performed 21 times for 19 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 395 times for 251 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 118 times for 111 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 640 times for 443 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 226 times for 171 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution

This process checks how well certain drugs, like antibiotics, can fight against infections. It involves mixing the drug with a microbe (like bacteria or a virus) in a lab. By observing how the microbe reacts, it helps determine the best drug to treat your infection.

This service was performed 49 times for 40 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 141 times for 98 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 99 times for 79 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 47 times for 32 patients

Initial hospital inpatient care per day, typically 30 minutes

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

This service was performed 34 times for 32 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 25 times for 25 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 41 times for 33 patients

Injection, degarelix, 1 mg

Degarelix injection is a medication administered under the skin to manage certain health conditions. It works by reducing specific hormone levels in the body to slow down disease progression. The dosage is 1 mg, and it is typically given by a healthcare professional.

This service was performed 5,920 times for 38 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 4,260 times for 32 patients

Injection, mitomycin, 5 mg

Mitomycin injection is a medication used to treat certain types of cancer. It works by slowing or stopping the growth of cancer cells. The 5mg dosage refers to the amount of the active ingredient, Mitomycin, in the injection.

This service was performed 288 times for 12 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 255 times for 231 patients

Insertion of stent in ureter using an endoscope

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

This service was performed 37 times for 20 patients

Instillation of anti-cancer drug into bladder

This procedure involves introducing a medication into the bladder to help fight off harmful cells. A small tube is gently placed into the area where urine exits the body. Through this tube, the medication is delivered directly into the bladder for maximum effectiveness.

This service was performed 293 times for 99 patients

Leuprolide acetate (for depot suspension), 7.5 mg

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

This service was performed 345 times for 72 patients

Prostate resection

Prostate resection is a procedure performed to alleviate discomfort caused by an enlarged prostate. This involves removing a portion of the prostate gland to ease pressure on the urinary tract, improving urine flow and reducing symptoms. It's performed under general or spinal anesthesia.

This service was performed for 1-10 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 325 times for 215 patients

Simple bladder irrigation and/or instillation

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

This service was performed 17 times for 17 patients

Simple insertion of temporary bladder tube

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

This service was performed 33 times for 24 patients

Testosterone (hormone) level, total

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

This service was performed 196 times for 118 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 55 times for 55 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 85 times for 48 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 for a new patient copayment and $17.52 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 23462 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 85.73, 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 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: 85.73 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: 63.57

  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: 100

  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: 88.87

  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: 88.87

  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.

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. Michael Williams is affiliated with the following medical facilities:

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Frequently Asked Questions