DR. JOHN MICHAEL WILLIAMS MD
NPI 1457389678
Dermatology in Summit, NJ

Medicare Participation & PECOS Enrollment Status

John Williams 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.

John Williams 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: 3870565435

  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: I20080327000062

  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.

Acne surgery

Acne surgery is a procedure to clear up severe acne that doesn't respond to other treatments. It involves a dermatologist using specialized tools to remove blackheads, whiteheads, and pimples. This helps to reduce the appearance of acne and prevent future breakouts.

This service was performed 16 times for 16 patients

All potassium hydroxide (koh) preparations

Potassium hydroxide (KOH) preparations are used in medical testing to identify fungal infections. In this procedure, a sample (like skin, hair, or nail) is collected and treated with KOH solution. This destroys non-fungal cells, making it easier to spot fungi under a microscope.

This service was performed 33 times for 27 patients

Complicated or multiple drainage of skin abscess

This procedure involves draining one or more skin abscesses, which are pockets of pus that form due to an infection. The process includes making a small cut on the abscess, removing the pus, and cleaning the area to promote healing and prevent further infection.

This service was performed 49 times for 48 patients

Destruction of precancer skin growth, 1 growth

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

This service was performed 196 times for 156 patients

Destruction of precancer skin growth, 15 or more growths

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

This service was performed 44 times for 36 patients

Destruction of precancer skin growth, 2-14 growths

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

This service was performed 593 times for 121 patients

Destruction of skin growth, 1-14 growths

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

This service was performed 261 times for 217 patients

Destruction of skin growth, 15 or more growths

"Destruction of skin growth" refers to a procedure where unwanted skin growths, such as warts or moles, are removed. In this case, 15 or more growths are treated. Techniques may include freezing, burning, or laser therapy. It's a safe, quick process to improve skin health.

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 27 times for 22 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 659 times for 394 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 286 times for 212 patients

Incision biopsy, first skin growth

An incision biopsy involves taking a small sample of a skin growth for further examination. A local anesthetic is used to numb the area, then a portion of the growth is removed using a surgical knife. This helps identify the nature of the growth.

This service was performed 14 times for 14 patients

Injection into skin growth, 1-7 growths

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

This service was performed 30 times for 23 patients

Injection into skin growth, more than 7 growths

This procedure involves injecting medication into multiple skin growths (more than 7) to either shrink them or eliminate them. It's a safe, minimally invasive method often used for benign growths. Comfort during the process is ensured.

This service was performed 42 times for 24 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 77 times for 20 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 147 times for 43 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 171 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 35 times for 35 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 18 times for 18 patients

Punch biopsy, first skin growth

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

This service was performed 24 times for 22 patients

Removal of cancer skin growth of body, arms, or legs, 0.6-1.0 cm

This procedure involves the surgical removal of a cancerous skin growth that measures between 0.6-1.0 cm, found on the body, arms, or legs. The goal is to eliminate cancer cells to prevent further spread. It's a common, safe, and effective treatment.

This service was performed 16 times for 14 patients

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the surgical removal of a cancerous skin growth on the body, arms, or legs. The growth is between 1.1 and 2.0 cm in size. The goal is to eliminate cancer cells and prevent them from spreading to other parts of the body.

This service was performed 89 times for 55 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves the careful removal of a small cancerous growth on the face, ears, eyelids, nose, lips, or mouth. It's a precise operation performed by a specialist to ensure complete removal of the cancer while preserving healthy tissue.

This service was performed 33 times for 31 patients

Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

This procedure involves the surgical removal of a cancerous skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth is between 1.1-2.0 cm in size. This is done to prevent the cancer from spreading and to restore health.

This service was performed 30 times for 22 patients

Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

This procedure involves the careful removal of a cancerous skin growth measuring between 1.1 to 2.0 cm, located on the scalp, neck, hands, or feet. The goal is to eliminate the cancer and prevent its spread. This is done under local anesthesia to minimize discomfort.

This service was performed 22 times for 18 patients

Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on your body, arms, or legs. The growth is between 0.6-1.0 cm in size. It's typically a simple process where the growth is cut away and the area is then stitched up for healing.

This service was performed 164 times for 122 patients

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth on the body, arms, or legs that is between 1.1 and 2.0 cm in size. It's a safe and routine procedure performed by a medical professional to improve your skin health and appearance.

This service was performed 204 times for 139 patients

Removal of noncancer skin growth of body, arms, or legs, 2.1-3.0 cm

This is a procedure where a noncancerous skin growth, sized 2.1-3.0 cm, on the body, arms, or legs is removed. It's typically done under local anesthesia. The process involves cutting out the growth and stitching the skin back together. The aim is to eliminate discomfort and prevent potential health issues.

This service was performed 14 times for 14 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on areas of the face such as the nose, lips, mouth, ears, or eyelids. The growth size is between 0.6-1.0 cm. The goal is to improve comfort, function, or appearance.

This service was performed 63 times for 57 patients

Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth on your face, ears, eyelids, nose, lips, or mouth that measures between 1.1-2.0 cm. It's a safe process to enhance your comfort and appearance.

This service was performed 45 times for 38 patients

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

This procedure involves the removal of a noncancerous skin growth on areas like the scalp, neck, hands, or feet. The size of the growth is between 0.6-1.0 cm. The process is performed by a medical professional and helps maintain skin health.

This service was performed 37 times for 33 patients

Removal of noncancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm

This procedure involves the removal of a noncancerous skin growth in areas such as the scalp, neck, hands, or feet. The growth being removed is between 1.1 to 2.0 cm in size. The process is safe, typically involves local anesthesia, and is performed by a healthcare professional.

This service was performed 46 times for 38 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 13 times for 12 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 29 times for 24 patients

Removal of skin tag, 1-15 skin tags

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

This service was performed 33 times for 32 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

This service was performed 219 times for 136 patients

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm

This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.

This service was performed 173 times for 122 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

This service was performed 25 times for 25 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm

This procedure involves the careful removal of a small skin growth, between 0.6-1.0 cm in size, from the scalp, neck, hands, or feet. It's done using a special tool to gently shave off the growth, ensuring minimal discomfort.

This service was performed 13 times for 13 patients

Simple or single drainage of skin abscess

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

This service was performed 20 times for 20 patients

Simple separation of fingernail or toenail from nail bed, each additional nail

This procedure involves the careful removal of a fingernail or toenail from its nail bed. It's commonly done to treat conditions like an ingrown nail or fungal infection. Additional nails can also be removed if necessary. The process is typically painless due to local anesthesia.

This service was performed 24 times for 19 patients

Simple separation of fingernail or toenail from nail bed, first nail

This procedure involves the gentle removal of the first nail from its bed, often due to injury or infection. It's performed under local anesthesia to minimize discomfort. The nail will gradually regrow over time.

This service was performed 31 times for 25 patients

Varicose vein removal

Varicose vein removal is a procedure to eliminate enlarged and twisted veins, commonly found in legs. It's performed when these veins cause discomfort or skin problems. The procedure may involve laser treatment, sclerotherapy (injecting a solution to close the veins), or surgery to remove the veins. It's generally safe and helps to alleviate symptoms.

This service was performed for 1-10 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.52 for a new patient copayment and $19.77 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 07901 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 75 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: N/A

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: N/A

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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. John Williams is affiliated with the following medical facilities:

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