ATUL P LALANI M.D.
NPI 1447231774
Internal Medicine - Endocrinology, Diabetes & Metabolism in Scottsdale, AZ

Medicare Participation & PECOS Enrollment Status

Atul Lalani 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.

Atul Lalani 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: 7214903608

  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: I20040908000022

  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)

  Supplies for maintenance of insulin infusion catheter, per week (HCPCS:A4224)

  4 DME suppliers used 17 Medicare Claims 205 Services Paid

• DME-Other DME (DE017N)

  Supplies for external insulin infusion pump, syringe type cartridge, sterile, each (HCPCS:A4225)

  4 DME suppliers used 16 Medicare Claims 505 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:A4238)

  1 DME suppliers used 13 Medicare Claims 13 Services Paid

• DME-Other DME (DE017N)

  Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

  16 DME suppliers used 33 Medicare Claims 186 Services Paid

• DME-Other DME (DE017N)

  External ambulatory infusion pump, insulin (HCPCS:E0784)

  7 DME suppliers used 48 Medicare Claims 48 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)

  7 DME suppliers used 137 Medicare Claims 147 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.

Amylase (enzyme) level

Amylase is an enzyme that helps break down starches into sugars during digestion. An amylase level test measures the amount of this enzyme in your blood or urine. This test helps identify conditions like pancreatitis or other digestive issues.

This service was performed 239 times for 157 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 553 times for 309 patients

Blood test, lipids (cholesterol and triglycerides)

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

This service was performed 419 times for 261 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 567 times for 311 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 479 times for 280 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 137 times for 121 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

This service was performed 234 times for 116 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment

This process involves a tiny sensor placed under your skin that checks your blood sugar levels in tissue fluid regularly. The sensor sends these readings to a device, allowing you to track your levels in real-time. This is provided by your healthcare provider.

This service was performed 76 times for 70 patients

Cortisol (hormone) measurement, total

Cortisol measurement is a test that checks the level of cortisol, a hormone, in your body. It's often used to assess stress levels or check for conditions like Addison's disease or Cushing's syndrome. This involves a simple blood or saliva sample.

This service was performed 157 times for 92 patients

C-peptide (protein) level

A C-peptide test measures the level of this protein in your blood. It's produced when your body makes insulin, a hormone that regulates your blood sugar. This test helps check how well your body is producing insulin and can aid in diagnosing conditions like diabetes.

This service was performed 377 times for 229 patients

Cyanocobalamin (vitamin b-12) level

A Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.

This service was performed 474 times for 301 patients

Dxa bone density measurement of forearm, finger, hand, or foot

A DXA bone density measurement of the forearm, finger, hand, or foot is a non-invasive procedure that uses X-rays to measure the amount of calcium and other minerals in your bones. This test helps to assess the strength of your bones and your risk of fractures.

This service was performed 22 times for 22 patients

Dxa bone density measurement of hip, pelvis, spine

A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.

This service was performed 141 times for 139 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 54 times for 47 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 1,600 times for 508 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 40 times for 32 patients

Fine needle aspiration biopsy using ultrasound guidance, each additional growth

A fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is used to collect cells from a growth. Ultrasound helps accurately locate the growth. If there's more than one growth, each one is biopsied separately.

This service was performed 95 times for 44 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

This service was performed 52 times for 48 patients

Folic acid level, serum

A Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.

This service was performed 483 times for 298 patients

Gonadotropin, follicle stimulating (reproductive hormone) level

This is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.

This service was performed 29 times for 25 patients

Gonadotropin, luteinizing (reproductive hormone) level

This is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.

This service was performed 29 times for 26 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 326 times for 227 patients

Infusion into a vein for hydration, 31-60 minutes

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

This service was performed 56 times for 17 patients

Infusion into a vein for hydration, each additional hour

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

This service was performed 66 times for 21 patients

Infusion, normal saline solution , 1000 cc

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

This service was performed 96 times for 21 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 653 times for 88 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 570 times for 82 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 229 times for 143 patients

Lipase (fat enzyme) level

A Lipase Level test measures the amount of lipase in your blood. Lipase is an enzyme that helps your body digest fats. High or low levels can indicate problems with your pancreas, such as pancreatitis or other conditions. This test helps your doctor diagnose and monitor these conditions.

This service was performed 244 times for 167 patients

Magnesium level

A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.

This service was performed 93 times for 77 patients

Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody

This procedure checks for antibodies to the COVID-19 virus in your blood. It indicates whether you've had a past infection. The body produces these antibodies while fighting off the virus. It's not a test for current infection.

This service was performed 265 times for 92 patients

Measurement of total estradiol (hormone)

Total estradiol measurement is a simple blood test that examines the level of a key hormone in your body. This hormone plays a vital role in many body functions. The test helps understand if hormone levels are balanced, which can impact overall health.

This service was performed 22 times for 14 patients

Microsomal antibodies (autoantibody) measurement

Microsomal antibodies measurement is a blood test to detect specific antibodies that your immune system may produce. It's often used to diagnose autoimmune conditions like thyroid disorders. The test is simple, involving a standard blood draw.

This service was performed 127 times for 108 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 47 times for 47 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 21 times for 14 patients

Parathormone (parathyroid hormone) level

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

This service was performed 490 times for 290 patients

Phosphate level

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

This service was performed 106 times for 85 patients

Prolactin (milk producing hormone) level

A prolactin level test measures the amount of a hormone, prolactin, in your blood. This hormone plays a role in many bodily functions, such as the creation of milk. High or low levels can indicate certain health conditions. The test involves a simple blood draw.

This service was performed 42 times for 37 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 52 times for 50 patients

Test for detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody, qualitative or semiquantitative

This test checks for antibodies in your body that may indicate a past COVID-19 infection. It's not a test for current infection. Antibodies are proteins your body makes in response to infections. The test is usually done with a blood sample.

This service was performed 135 times for 92 patients

Testing of autonomic (sympathetic) nervous system function

Testing of autonomic nervous system function assesses how well your body's automatic processes, like heart rate and blood pressure, are working. It involves various non-invasive tests like heart rate variability and sweat production tests.

This service was performed 139 times for 121 patients

Testing of autonomic nervous system function and heart rate response to deep breathing

This test studies the autonomic nervous system, which controls body functions like heart rate. During the test, you'll breathe deeply while the heart rate is monitored. This helps identify any irregularities in the heart's response to breathing changes.

This service was performed 137 times for 122 patients

Testosterone (hormone) level, free

A free testosterone level test measures the amount of unattached, or "free," testosterone in your blood. Testosterone is a hormone that's important for certain body functions. This test is used to check if your hormone level is in the normal range.

This service was performed 30 times for 21 patients

Thyroid hormone, t3 measurement, free

The T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.

This service was performed 571 times for 313 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 560 times for 313 patients

Ultrasound scan of head and neck soft tissue

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

This service was performed 384 times for 293 patients

Urine microalbumin (protein) level

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

This service was performed 252 times for 161 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 492 times for 293 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $24.5 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 85251 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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Frequently Asked Questions