DR. GARY L SHAPIRA MD
NPI 1366426876
Pathology - Anatomic Pathology & Clinical Pathology in Detroit, MI

Medicare Participation & PECOS Enrollment Status

Gary Shapira 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.

Gary Shapira 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: 3476613381

  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: I20081122000060

  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

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.

Blood smear interpretation by physician with written report

Blood smear interpretation is a lab test where your doctor examines a sample of your blood under a microscope. They look for abnormalities in your blood cells which can help diagnose various conditions. You'll receive a written report of the findings.

This service was performed 114 times for 108 patients

Bone marrow, smear interpretation

Bone marrow smear interpretation is a procedure where a small sample of your bone marrow is taken and examined under a microscope. This helps doctors identify any abnormal cells or signs of diseases such as anemia, leukemia, or infections. It's a crucial step in diagnosing various blood disorders.

This service was performed 13 times for 13 patients

Cell examination of specimen, selective cellular enhancement technique

Cell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.

This service was performed 89 times for 72 patients

Evaluation of fine needle aspirate with interpretation and report

This procedure involves using a thin needle to collect a small sample from an abnormal area or lump. The sample is then examined under a microscope to identify any potential issues. A report of the findings is provided for further analysis.

This service was performed 24 times for 15 patients

Immunologic analysis technique on serum (immunofixation)

Immunofixation is a lab test that helps identify proteins called immunoglobulins in your blood serum. These proteins are part of your immune system. Changes in their levels can indicate certain diseases. The test is simple and only requires a blood sample.

This service was performed 102 times for 99 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 51 times for 25 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 820 times for 466 patients

Pathology examination of tissue using a microscope, limited examination

A pathology examination of tissue using a microscope is a procedure where a small sample of your tissue is observed under a microscope. This limited examination helps identify any abnormal cells or signs of disease, aiding in accurate diagnosis and treatment planning.

This service was performed 50 times for 46 patients

Pathology examination of tissue using a microscope, moderately high complexity

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

This service was performed 60 times for 46 patients

Pathology examination of tissue using a microscope, moderately low complexity

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

This service was performed 53 times for 47 patients

Preparation of tissue for examination by removing any calcium present

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

This service was performed 75 times for 68 patients

Protein measurement, serum

A serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.

This service was performed 108 times for 106 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 58 times for 24 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 173 times for 42 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 121 times for 104 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 26 times for 22 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.57 for a new patient copayment and $25.58 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 48214 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.

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. Gary Shapira is affiliated with the following medical facilities:

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Frequently Asked Questions