DR. JOSEPH R. SPIEGEL M.D.
NPI 1467472175
Otolaryngology in Philadelphia, PA

Medicare Participation & PECOS Enrollment Status

Joseph Spiegel 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.

Joseph Spiegel 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: 8628038023

  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: I20041011000506, I20190603000210

  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.

Unknown

• Other-Enteral and Parenteral (OB006N)

  Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4036)

  1 DME suppliers used 12 Medicare Claims 360 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4152)

  2 DME suppliers used 21 Medicare Claims 14067 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4155)

  1 DME suppliers used 11 Medicare Claims 759 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.

Diagnostic exam of esophagus using a flexible endoscope through mouth

This procedure, known as an esophagogastroduodenoscopy (EGD), involves inserting a flexible tube with a camera through the mouth to examine the esophagus. It helps doctors diagnose issues like inflammation, ulcers, or other abnormalities. It's a safe, usually painless process.

This service was performed 12 times for 12 patients

Diagnostic exam of lung airway using an endoscope

This procedure involves a doctor inserting a thin, flexible tube called an endoscope into your lung airway. It allows the doctor to view the airway and diagnose any issues. The process is safe and helps in accurate diagnosis.

This service was performed 33 times for 28 patients

Diagnostic exam of voice box using a flexible endoscope

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

This service was performed 47 times for 39 patients

Diagnostic exam of voice box using an endoscope

This procedure involves the use of a thin, flexible instrument called an endoscope to examine the voice box. The endoscope is gently inserted through the nose or mouth to provide a clear view of the voice box. It helps in diagnosing issues related to speech, breathing, or swallowing.

This service was performed 15 times for 15 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 37 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 188 times for 157 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 34 times for 31 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 458 times for 271 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 77 times for 54 patients

Evaluation and recording of swallowing using an endoscope

This procedure, known as endoscopic evaluation of swallowing, involves using a thin, flexible tube with a camera (endoscope) to view your throat and evaluate your swallowing. It helps identify any issues that may be causing difficulty in swallowing.

This service was performed 20 times for 19 patients

Evaluation, recording, and interpretation of swallowing using an endoscope

This procedure, known as endoscopic evaluation of swallowing, involves passing a thin, flexible tube with a light and camera through your nose to your throat. It helps doctors observe your swallowing process in real time, identify any issues, and plan appropriate treatments.

This service was performed 19 times for 19 patients

Exam of windpipe and lung airways through permanent windpipe opening using an endoscope

This procedure involves examining your windpipe and lung airways through a permanent opening in your windpipe. An endoscope, a thin tube with a light and camera, is used to visualize these areas. The goal is to diagnose or monitor conditions affecting your respiratory system.

This service was performed 38 times for 14 patients

Exam to assess movement of vocal cord flaps using an endoscope

This procedure involves using a thin, flexible tube called an endoscope to view your vocal cords. The endoscope is gently inserted through your nose or mouth to observe the movement of your vocal cords. This helps identify any abnormalities or issues.

This service was performed 684 times for 411 patients

Exam to assess movement of vocal cord flaps using an endoscope

This procedure involves using a thin, flexible tube called an endoscope to view your vocal cords. The endoscope is gently inserted through your nose or mouth to observe the movement of your vocal cords. This helps identify any abnormalities or issues.

This service was performed 105 times for 74 patients

Imaging of voice box with speech evaluation

This procedure involves capturing images of your voice box, or larynx, while you speak. It helps evaluate how your voice box functions when you talk. The process is non-invasive and painless, aiding in diagnosing any issues related to speech or voice quality.

This service was performed 69 times for 48 patients

Imaging of voice box with speech evaluation

This procedure involves capturing images of your voice box, or larynx, while you speak. It helps evaluate how your voice box functions when you talk. The process is non-invasive and painless, aiding in diagnosing any issues related to speech or voice quality.

This service was performed 15 times for 12 patients

Injection into vocal cords using an endoscope with operating microscope or telescope

This procedure involves using a thin, flexible tube called an endoscope along with a special microscope or telescope. The endoscope is carefully inserted into your throat to reach your vocal cords. Then, a precise injection is made into the vocal cords to treat various conditions.

This service was performed 15 times for 12 patients

Injection of chemical for paralysis of nerve muscles on side of voice box

This procedure involves injecting a chemical into the nerve muscles on one side of your voice box. The chemical temporarily paralyzes these muscles, helping to manage conditions that affect voice and swallowing. It's a safe, often temporary measure to improve your quality of life.

This service was performed 58 times for 23 patients

Injection of chemical for paralysis of nerve muscles on side of voice box

This procedure involves injecting a chemical into the nerve muscles on one side of your voice box. The chemical temporarily paralyzes these muscles, helping to manage conditions that affect voice and swallowing. It's a safe, often temporary measure to improve your quality of life.

This service was performed 27 times for 14 patients

Injection of drug into side of voice box using an endoscope

This procedure involves the use of a thin tube called an endoscope to deliver medication directly into the side of your voice box. This method allows for precise placement of the drug, helping to address specific issues with your voice or throat.

This service was performed 27 times for 13 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 32 times for 32 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 64 times for 64 patients

Removal of growth of tongue and/or stripping of vocal cord using an endoscope with operating microscope or telescope

This procedure involves using a small, flexible tube with a camera (endoscope) to view and remove a growth on the tongue or strip the vocal cords. An operating microscope or telescope may be used to enhance visibility. It's a safe, effective way to treat these conditions.

This service was performed 21 times for 15 patients

Removal of impacted ear wax

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

This service was performed 25 times for 21 patients

Repair of side of voice box by moving vocal cord to middle

This procedure involves adjusting your vocal cord to improve voice quality. The surgeon moves the cord towards the middle of your voice box, helping it connect better with the opposite cord. This can enhance your voice and help with any difficulties you may have been experiencing.

This service was performed 16 times for 15 patients

Upper gastrointestinal (GI) endoscopy for acid reflux

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

This service was performed for 46 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.29 for a new patient copayment and $18.61 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 19107 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. Joseph Spiegel is affiliated with the following medical facilities:

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