MR. JONATHAN H SUMNER M.D.
NPI 1427030097
Internal Medicine - Cardiovascular Disease in Rockville Centre, NY

Medicare Participation & PECOS Enrollment Status

Jonathan Sumner 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.

Jonathan Sumner 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: 7416944418

  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: I20040430000156

  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.

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 22 times for 22 patients

Complete ultrasound of within the brain blood flow

A complete ultrasound of brain blood flow, also known as a Transcranial Doppler, is a non-invasive procedure that uses sound waves to measure the speed and direction of blood flow in the brain. This helps detect any abnormalities or blockages.

This service was performed 41 times for 38 patients

Complete ultrasound study of arm and leg arteries

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

This service was performed 31 times for 31 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 68 times for 41 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 253 times for 89 patients

Evaluation of brain response to sound for determination of hearing threshold with interpretation and report

This procedure tests how your brain responds to sound to determine your hearing ability. Sounds are played and your brain's responses are recorded and analyzed. This helps identify any hearing issues you may have.

This service was performed 31 times for 30 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 70 times for 46 patients

Measurement of nerve conduction patterns of eye blink reflex

The measurement of nerve conduction patterns of the eye blink reflex is a test that checks the health of your facial nerves. It involves a gentle stimulation near your eye to trigger a blink, and then records how quickly and effectively your nerves respond. This can help diagnose conditions affecting your nervous system.

This service was performed 29 times for 28 patients

Placement of skin electrodes and measurement of stimulated sites in arms

This procedure involves placing small, sticky patches called electrodes on your arms. These electrodes send tiny electrical signals to specific areas, which are then measured. This helps to assess the health of your nerves and muscles. It's safe and generally painless.

This service was performed 30 times for 29 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 43 times for 38 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 160 times for 142 patients

Test for abnormal eye movement using 3 positions with recording

This test checks for unusual eye movements. You'll be asked to look in three different directions while a device records your eye movements. It helps identify any eye muscle or nerve issues. It's non-invasive and painless.

This service was performed 31 times for 30 patients

Test for abnormal eye movement using a moving target that moves back and forth with recording

This test examines eye movement by tracking your eyes as they follow a moving target. It helps detect any irregularities in eye motion. A device records your eye movements to provide accurate results. This information assists in diagnosing various eye conditions.

This service was performed 30 times for 29 patients

Test for abnormal eye movement using a moving target with recording

This test involves following a moving target with your eyes while a device records your eye movements. It helps identify any irregularities in eye movement, which can indicate certain health conditions. The procedure is non-invasive and painless.

This service was performed 31 times for 30 patients

Test for abnormal eye movement using a rotating chair

A rotating chair test helps doctors assess balance issues. You'll sit in a motorized chair that spins at controlled speeds. As the chair moves, your eye movements are monitored to identify any irregularities, which can indicate balance disorders.

This service was performed 30 times for 29 patients

Test for abnormal eye movement with recording

This procedure checks for unusual eye movement. It involves recording your eye movements while you follow a light or object with your eyes. This helps identify any issues with how your eyes move or focus, aiding in the diagnosis of certain conditions.

This service was performed 31 times for 30 patients

Ultrasound of both sides of head and neck blood flow

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

This service was performed 44 times for 44 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 61 times for 60 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 61 times for 60 patients

Ultrasound of leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

This service was performed 26 times for 26 patients

Ultrasound of within the brain blood flow following medication

An ultrasound of the brain's blood flow after medication is a non-invasive procedure that uses sound waves to create images of the blood flow within your brain. This helps monitor how the medication is affecting your brain's blood circulation.

This service was performed 41 times for 38 patients

Ultrasound of within the brain blood flow for blood clots

An ultrasound of the brain's blood flow is a safe, non-invasive procedure that uses sound waves to create images of the blood vessels. This helps identify any blockages, like blood clots, that might disrupt normal blood flow and cause health issues.

This service was performed 41 times for 38 patients

Ultrasound study of arm or leg veins with compression and maneuvers

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

This service was performed 26 times for 25 patients

Use of electrodes during balance testing

Balance testing with electrodes involves attaching small sensors to your skin. These sensors record your body's responses to various balance tests. They help in assessing your balance and coordination by measuring your body's electrical activity as you perform specific tasks.

This service was performed 30 times for 29 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $38.57 for a new patient copayment and $20.86 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 11570 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.

Reviews for MR. JONATHAN H SUMNER M.D.

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

Frequently Asked Questions