DR. PEDRO MIGUEL PEREIRA M.D.
NPI 1477512432
Internal Medicine in Oakland, NJ


Quality Rating: 99.75 out of 100 score

NPI Status: Active since March 20, 2006

Contact Information

9 POST RD
SUITE D7
OAKLAND, NJ
ZIP 07436
Phone: (201) 337-1700
Fax: (201) 337-1703

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  • Individual
  • Male
  • Years of Experience 28
  • Internal Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About PEDRO PEREIRA

Pedro Pereira is an internist established in Oakland, New Jersey and his medical specialization is Internal Medicine with more than 28 years of experience. He graduated from Rutgers New Jersey Medical School in 1996. The healthcare provider is registered in the NPI registry with number 1477512432 assigned on March 2006. The practitioner's primary taxonomy code is 207R00000X with license number 25MA06772300 (NJ). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1477512432
Provider Name
DR. PEDRO MIGUEL PEREIRA M.D.
Gender
Male
Entity Type
Individual
Location Address
9 POST RD SUITE D7 OAKLAND, NJ 07436
Location Phone
(201) 337-1700
Location Fax
(201) 337-1703
Mailing Address
9 POST RD SUITE D7 OAKLAND, NJ 07436
Mailing Phone
(201) 337-1700
Mailing Fax
(201) 337-1703
Medical School Name
RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduation Year
1996
Is Sole Proprietor?
Yes
Enumeration Date
03-20-2006
Last Update Date
08-23-2023
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An internist like Pedro Pereira is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Pedro Pereira 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.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 99.75, 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 following quality measures were reported for this provider: e-prescribing, medication reconciliation, patient-specific education, provide patient access, secure messaging and security risk analysis.

The typical physician office visit costs for Medicare beneficiaries in this area are: $37.64 for a new patient copayment and $29.21 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
25MA06772300
License State
NJ
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
8107009MEDICAID (05)NJ 

PECOS Enrollment and Medicare Participation Status

Pedro Pereira 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: 941309462

    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: I20070625000576

    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

  • Other DME (D1E)

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

    7 DME suppliers used 22 Medicare Claims 69 Services Paid

  • Other DME (D1E)

    Lancets, per box of 100 (HCPCS:A4259)

    5 DME suppliers used 15 Medicare Claims 23 Services Paid

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 25 Medicare Claims 25 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Wheelchairs (D1D)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Wheelchairs (D1D)

    Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

    1 DME suppliers used 12 Medicare Claims 12 Services Paid

Physician Visit Costs

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 07436 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $150.56
  • Minimum New Patient Price $66.45
  • Maximum New Patient Price $198.48
  • Average New Patient Copayment $37.64
  • Minimum New Patient Copayment $16.61
  • Maximum New Patient Copayment $49.62

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $116.86
  • Minimum Established Patient Price $21.27
  • Maximum Established Patient Price $162.58
  • Average Established Patient Copayment $29.21
  • Minimum Established Patient Copayment $5.31
  • Maximum Established Patient Copayment $40.64

* 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 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: 99.75 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: 99.5

    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: 100

    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: 40

    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.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
e-Prescribing 71% 2991
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Medication Reconciliation 97% 89
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 96% 845
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 94% 845
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 36% 845
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 202

    Insertion of needle into vein for collection of blood sample (HCPCS:36415)

  • 83

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 69

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 31

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 24

    Administration of pneumococcal vaccine (HCPCS:G0009)

  • 12

    Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)

Hospital Affiliations

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. Pedro Pereira is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HACKENSACK UNIVERSITY MEDICAL CENTER30 PROSPECT AVE
HACKENSACK, NJ 7601
(551) 996-2000Acute Care Hospitals
VALLEY HOSPITAL223 N VAN DIEN AVENUE
RIDGEWOOD, NJ 7450
(201) 447-8000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1477512432
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
24147101446
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 4 + 7 + 1 + 0 + 1 + 4 + 4 + 6 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1477512432 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 17 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1689642787DR. EUGENE B PAPOWITZ M.D.
Individual
Psychologist9 POST RD SUITE D-1
OAKLAND, NJ 07436
(201) 337-3994
1376512962 LYNDA J EISEN PT
Individual
Physical Therapist9 POST RD
OAKLAND, NJ 07436
(201) 337-8410
1982615829DR. RICHARD G RIVMAN DDS
Individual
Dentist9 POST RD SUITE M6
OAKLAND, NJ 07436
(201) 405-0700
1346338340DR. LYNDA ANN FARRELL M.D.
Individual
Internal Medicine9 POST RD SUITE M7
OAKLAND, NJ 07436
(201) 337-9498
1205919164DR. FRANKLIN D. MAC ARTHUR PSY. D.
Individual
Psychologist (Clinical)9 POST RD BUILDING D, SUITE 6
OAKLAND, NJ 07436
(201) 669-6320
1073673687DR. NEIL JEFFREY DORNFELD DMD
Individual
Dentist (General Practice)9 POST RD SUITE M1A
OAKLAND, NJ 07436
(201) 337-6135
1093872103DR. EDWARD LEO CONNOLLY PH.D.
Individual
Clinical Neuropsychologist9 POST RD SUITE D-1
OAKLAND, NJ 07436
(201) 405-1991
1275658122 SHAHRZAD TAJTARAGHI DDS
Individual
Dentist (General Practice)9 POST RD #D2 OAKLAND FAMILY DENTISTRY PA
OAKLAND, NJ 07436
(201) 337-8377
1447378435MOUNTAINVIEW MEDICAL GROUP PC
Organization
Internal Medicine9 POST RD SUITE D7
OAKLAND, NJ 07436
(201) 337-1700
1124244884DR. RICHARD LUTHER BUCHER JR. D.M.D.
Individual
Dentist (General Practice)9 POST RD SUITE D5
OAKLAND, NJ 07436
(201) 337-9496
1396078010 MARVIN LAGSTEIN
Individual
Dentist9 POST RD SUITE # M1A
OAKLAND, NJ 07436
(201) 337-6135
1659716538CATALYST COUNSELING SERVICES
Organization
Community/Behavioral Health9 POST RD BLDG SUITE 6
OAKLAND, NJ 07436
(201) 572-3600
1083658637DR. IRA ARTHUR JACOBS DMD
Individual
Dentist9 POST RD SUITE D8
OAKLAND, NJ 07436
(201) 337-4666
1073948113IRA A JACOBS DMD
Organization
Dentist9 POST RD SUITE D8
OAKLAND, NJ 07436
(201) 337-4666
1477886190 DANIEL ALLEN
Individual
Dentist (Pediatric Dentistry)9 POST RD SUITE # M1A
OAKLAND, NJ 07436
(201) 337-6135
1922090950GARDEN STATE ORTHOPAEDIC CENTER, INC.
Organization
Prosthetic/Orthotic Supplier9 POST RD SUITE 0P-1
OAKLAND, NJ 07436
(201) 337-5566
1760607956LASER DENTISTRY OF NORTH JERSEY, LLC.
Organization
Dentist (General Practice)9 POST RD SUITE D5
OAKLAND, NJ 07436
(201) 337-9496

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477512432, enumerated in the NPI registry as an "individual" on March 20, 2006

The provider is located at 9 Post Rd Suite D7 Oakland, Nj 07436 and the phone number is (201) 337-1700

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 28 years of experience. He graduated from Rutgers New Jersey Medical School in 1996.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 14, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $150.56 with an average copayment of $37.64 for new patient appointments. Established patients should expect a typical charge of $116.86 and an average copayment of 29.21. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Insertion of needle into vein for collection of blood sample, Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Routine ekg using at least 12 leads including interpretation and report, Administration of pneumococcal vaccine and Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem.

The practitioner is affiliated to the following hospital(s): HACKENSACK UNIVERSITY MEDICAL CENTER and VALLEY HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on March 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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