DR. KELLY J SMITH MD
NPI 1528198405
Pediatrics - Pediatric Pulmonology in San Antonio, TX

Medicare Participation & PECOS Enrollment Status

Kelly Smith 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.

Kelly Smith 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: 8820173289

  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: I20080310000203

  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-Medical/Surgical Supplies (DA000N)

  Sterile water/saline, 500 ml (HCPCS:A4217)

  1 DME suppliers used 12 Medicare Claims 288 Services Paid

• DME-Other DME (DE000N)

  Tracheal suction catheter, any type other than closed system, each (HCPCS:A4624)

  2 DME suppliers used 21 Medicare Claims 1740 Services Paid

• DME-Other DME (DE000N)

  Oropharyngeal suction catheter, each (HCPCS:A4628)

  2 DME suppliers used 20 Medicare Claims 40 Services Paid

• DME-Other DME (DE000N)

  Canister, disposable, used with suction pump, each (HCPCS:A7000)

  2 DME suppliers used 25 Medicare Claims 82 Services Paid

• DME-Other DME (DE000N)

  Tubing, used with suction pump, each (HCPCS:A7002)

  2 DME suppliers used 11 Medicare Claims 82 Services Paid

• DME-Other DME (DE000N)

  Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

  2 DME suppliers used 24 Medicare Claims 48 Services Paid

• DME-Other DME (DE000N)

  Aerosol mask, used with dme nebulizer (HCPCS:A7015)

  2 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Other DME (DE001N)

  Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

  5 DME suppliers used 21 Medicare Claims 78 Services Paid

• DME-Other DME (DE005N)

  Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) (HCPCS:E0465)

  2 DME suppliers used 39 Medicare Claims 42 Services Paid

• DME-Other DME (DE005N)

  Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)

  2 DME suppliers used 13 Medicare Claims 24 Services Paid

• DME-Other DME (DE000N)

  Nebulizer, with compressor (HCPCS:E0570)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Other DME (DE000N)

  Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)

  2 DME suppliers used 17 Medicare Claims 17 Services Paid

• DME-Oxygen and Supplies (DC002N)

  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

• DME-Other DME (DE000N)

  Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

  5 DME suppliers used 15 Medicare Claims 15 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  Tracheostomy care kit for established tracheostomy (HCPCS:A4629)

  2 DME suppliers used 14 Medicare Claims 425 Services Paid

• DME-Orthotic Devices (DF000N)

  Tracheostomy mask, each (HCPCS:A7525)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

Drugs Administered Through DME

• DME-Drugs Administered Through DME (DG006N)

  Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

  4 DME suppliers used 15 Medicare Claims 7963 Services Paid

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