ROBERT M NARAGHI M.D.
NPI 1306950043
Urology in Orange, CA

Medicare Participation & PECOS Enrollment Status

Robert Naraghi 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.

Robert Naraghi 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: 1951379767

  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: I20040920001328

  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)

  1 DME suppliers used 82 Medicare Claims 163 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Lancets, per box of 100 (HCPCS:A4259)

  1 DME suppliers used 62 Medicare Claims 62 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 12 Medicare Claims 12 Services Paid

Unknown

• Treatment-Treatment - Miscellaneous (RX029N)

  Cyclosporine, oral, 100 mg (HCPCS:J7502)

  3 DME suppliers used 90 Medicare Claims 5160 Services Paid

• Treatment-Chemotherapy (RH002N)

  Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg (HCPCS:J7503)

  12 DME suppliers used 586 Medicare Claims 191150 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)

  32 DME suppliers used 2391 Medicare Claims 278280 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg (HCPCS:J7508)

  1 DME suppliers used 13 Medicare Claims 7800 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Prednisone, immediate release or delayed release, oral, 1 mg (HCPCS:J7512)

  20 DME suppliers used 2592 Medicare Claims 336330 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Cyclosporine, oral, 25 mg (HCPCS:J7515)

  4 DME suppliers used 231 Medicare Claims 32220 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Mycophenolate mofetil, oral, 250 mg (HCPCS:J7517)

  6 DME suppliers used 232 Medicare Claims 28140 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Mycophenolic acid, oral, 180 mg (HCPCS:J7518)

  28 DME suppliers used 2411 Medicare Claims 343044 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Sirolimus, oral, 1 mg (HCPCS:J7520)

  6 DME suppliers used 162 Medicare Claims 4842 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Everolimus, oral, 0.25 mg (HCPCS:J7527)

  2 DME suppliers used 69 Medicare Claims 16110 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for initial immunosuppressive drug(s), first month following transplant (HCPCS:Q0510)

  2 DME suppliers used 37 Medicare Claims 37 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)

  45 DME suppliers used 3078 Medicare Claims 3078 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)

  41 DME suppliers used 3123 Medicare Claims 5648 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.

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 127 times for 73 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 553 times for 287 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 15 times for 15 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 157 times for 130 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 45 times for 18 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 30 times for 17 patients

Hospital discharge day management, 30 minutes or less

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

This service was performed 16 times for 16 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 106 times for 89 patients

Insertion of stent in ureter

A ureteral stent is a soft, hollow tube placed temporarily into your ureter to help urine drain from your kidney to your bladder. It can assist with kidney stone passage or relieve a blockage. The procedure is done under anesthesia, and discomfort post-procedure is minimal.

This service was performed 46 times for 46 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 53 times for 38 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 26 times for 24 patients

Preparation of donor kidney and veins for transplantation

In kidney transplantation, a healthy kidney is taken from a donor. The kidney is carefully prepared, cleaned, and preserved. Veins are also prepared to ensure smooth blood flow to the new kidney. This process is done under strict medical protocols.

This service was performed 28 times for 28 patients

Preparation of donor kidney for transplantation

Preparation of a kidney for transplantation involves careful evaluation of the donor organ. It includes checking for diseases, ensuring compatibility, and preserving the organ in a cold solution until transplantation. This process ensures the best outcome for the recipient.

This service was performed 23 times for 23 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

This service was performed 17 times for 17 patients

Transplantation of donor kidney

Transplantation of a donor kidney involves replacing a non-functioning kidney with a healthy one from a donor. This procedure can significantly improve the quality of life for those with serious kidney disease. The new kidney can perform the essential task of filtering blood and removing waste.

This service was performed 50 times for 50 patients

Ultrasound scan of transplanted kidney

An ultrasound scan of a transplanted kidney is a non-invasive imaging procedure. It uses sound waves to produce images of your kidney, helping to monitor its health and function. This test helps detect any potential issues early, ensuring the kidney is working properly.

This service was performed 47 times for 36 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.59 for a new patient copayment and $19.49 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 92868 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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