RANDALL G NIXON M.D.
NPI 1346379187
Urology in Carson City, NV

Medicare Participation & PECOS Enrollment Status

Randall Nixon 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.

Randall Nixon 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: 7214012509

  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: I20110119000955

  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 61 Medicare Claims 14050 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)

  8 DME suppliers used 20 Medicare Claims 55 Services Paid

• DME-Orthotic Devices (DF000N)

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

  4 DME suppliers used 19 Medicare Claims 71 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 120 times for 59 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 2,065 times for 1,249 patients

Biopsy of prostate gland

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

This service was performed 20 times for 20 patients

Cell examination of specimen, concentration technique

Cell examination of a specimen using a concentration technique is a lab process that enhances the detection of cells in a sample. This method helps to focus on key areas of the sample, making it easier to spot abnormalities or changes. It's a crucial part of diagnosing and monitoring certain health conditions.

This service was performed 124 times for 100 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 63 times for 63 patients

Complex measurement of pressure of urine flow in bladder with urethra pressure and voiding pressure studies

This procedure helps to measure the pressure inside your bladder while passing fluid. It checks how well your bladder and the tube that carries fluid from your bladder are working. It's important for diagnosing issues with fluid flow and storage.

This service was performed 13 times for 13 patients

Creation of sling around urethra in female to control leakage

This procedure involves creating a supportive loop around a tube in your lower body that carries liquid waste. This helps manage any unwanted leakage, providing you with better control and comfort.

This service was performed 12 times for 12 patients

Crushing of stone of ureter with insertion of stent using an endoscope

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

This service was performed 19 times for 19 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 20 times for 15 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 185 times for 144 patients

Electronic assessment of bladder emptying

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

This service was performed 16 times for 16 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 19 times for 17 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 1,929 times for 1,191 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 416 times for 307 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 70 times for 57 patients

Exam with injections of chemical for destruction of bladder using an endoscope

This procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.

This service was performed 11 times for 11 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 27 times for 13 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 38 times for 33 patients

Incision of urethra using an endoscope

This is a minimally invasive procedure where a small instrument, called an endoscope, is used to make an incision in the urethra. The urethra is the tube that allows urine to pass out of the body. This procedure can help address certain health issues, ensuring a smoother flow of urine.

This service was performed 11 times for 11 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 11 times for 11 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 14 times for 14 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 67 times for 15 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 6,723 times for 11 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 136 times for 13 patients

Injection, onabotulinumtoxina, 1 unit

Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.

This service was performed 2,100 times for 11 patients

Insertion of device into abdomen with pressure and urine flow rate study

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

This service was performed 11 times for 11 patients

Insertion of lower leg neurostimulator electrode

The insertion of a lower leg neurostimulator electrode is a procedure where a small device is placed under your skin. This device sends mild electrical signals to nerves in the lower leg, helping to manage chronic pain. It's a safe, minimally invasive procedure.

This service was performed 147 times for 25 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 16 times for 15 patients

Insertion of temporary bladder tube

This procedure involves placing a small tube into your lower abdomen to help drain urine from your bladder. It's a temporary measure, often used when normal urination is not possible. The tube remains in place until you can urinate on your own again.

This service was performed 19 times for 18 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 376 times for 59 patients

New patient office or other outpatient visit, 45-59 minutes

This 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 267 times for 267 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 29 times for 29 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

This service was performed 13 times for 13 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 62 patients

Removal of prostate gland using an electrocautery knife through urethra with control of bleeding using an endoscope

This procedure involves the careful removal of a small gland located in the lower body using a special heated knife, inserted through a natural body passage. An endoscope, a thin tube with a light and camera, helps to manage any bleeding. The aim is to alleviate discomfort and improve overall health.

This service was performed 26 times for 26 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 95 times for 25 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 27 times for 27 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 125 times for 100 patients

Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method

This procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.

This service was performed 15 times for 15 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 775 times for 626 patients

Ultrasound scan of pelvic region through rectum

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

This service was performed 31 times for 31 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.81 for a new patient copayment and $17.78 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 89703 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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. Randall Nixon is affiliated with the following medical facilities:

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