DR. BISHOY F HANNA M.D.
NPI 1538507389
Internal Medicine - Critical Care Medicine in Sayreville, NJ

NPI Status: Active since June 13, 2013

Contact Information

73 WINDING WOOD DR APT 4A
SAYREVILLE, NJ
ZIP 08872
Phone: (908) 202-9198

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  • Individual
  • Male
  • Years of Experience 12
  • Internal Medicine
  • Critical Care Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About BISHOY HANNA

Bishoy Hanna is an internist established in Sayreville, New Jersey and his medical specialization is Internal Medicine with a focus in critical care medicine with more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1538507389 assigned on June 2013. The practitioner's primary taxonomy code is 207RC0200X with license number 25MA10125200 (NJ). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1538507389
Provider Name
DR. BISHOY F HANNA M.D.
Gender
Male
Entity Type
Individual
Location Address
73 WINDING WOOD DR APT 4A SAYREVILLE, NJ 08872
Location Phone
(908) 202-9198
Mailing Address
73 WINDING WOOD DR APT 4A SAYREVILLE, NJ 08872
Mailing Phone
(908) 202-9198
Medical School Name
OTHER
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
06-13-2013
Last Update Date
11-10-2022
Code Navigator

An internist like Bishoy Hanna 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.

Bishoy Hanna 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 and the following quality measures were reported: advance care planning, care plan, implementation of medication management practice improvements, measurement and improvement at the practice and panel level and participation in an ahrq-listed patient safety organization.. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

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 Critical Care Medicine

Taxonomy Code
207RC0200X
Type
Allopathic & Osteopathic Physicians
License No.
25MA10125200
License State
NJ
Taxonomy Description
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207LC0200XAllopathic & Osteopathic Physicians

Anesthesiology
Critical Care Medicine

25MA10125200 (NJ)
2207RC0200XAllopathic & Osteopathic Physicians

Internal Medicine
Critical Care Medicine

01087179A (IN)
3207RP1001XAllopathic & Osteopathic Physicians

Internal Medicine
Pulmonary Disease

25MA10125200 (NJ)

Insurance Plans Accepted

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

  • Blue Cross and Blue Shield of Texas

    • Blue Advantage Bronze HMO℠ 204 - HMO
    • Blue Advantage Bronze HMO℠ 301 - HMO
    • Blue Advantage Bronze HMO℠ 302 - HMO
    • Blue Advantage Bronze HMO℠ 707 - HMO
    • Blue Advantage Gold HMO℠ 206 - HMO
    • Blue Advantage Gold HMO℠ 603 - HMO
    • Blue Advantage Gold HMO℠ 706 - HMO
    • Blue Advantage Plus Bronze℠ 303 - POS
    • Blue Advantage Plus Bronze℠ 305 - POS
    • Blue Advantage Plus Bronze℠ 707 - POS
    • Blue Advantage Plus Gold℠ 203 - POS
    • Blue Advantage Plus Gold℠ 706 - POS
    • Blue Advantage Plus Gold℠ 803 - POS
    • Blue Advantage Plus Silver℠ 202 - POS
    • Blue Advantage Plus Silver℠ 605 - POS
    • Blue Advantage Plus Silver℠ 705 - POS
    • Blue Advantage Security HMO℠ 200 - HMO
    • Blue Advantage Silver HMO℠ 205 - HMO
    • Blue Advantage Silver HMO℠ 705 - HMO
    • Blue Advantage Silver HMO℠ 801 - HMO
  • CareSource

    • CareSource Marketplace Bronze First - HMO
    • CareSource Marketplace Bronze First Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Core Gold - HMO
    • CareSource Marketplace Core Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Core Silver - HMO
    • CareSource Marketplace Core Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Diabetes Gold - HMO
    • CareSource Marketplace Diabetes Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Diabetes Silver - HMO
    • CareSource Marketplace Diabetes Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Essential Silver - HMO
    • CareSource Marketplace Essential Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Gold - HMO
    • CareSource Marketplace Gold Dental, Vision, & Fitness - HMO
    • CareSource Marketplace HSA Eligible Bronze - HMO
    • CareSource Marketplace Low Premium Bronze - HMO
    • CareSource Marketplace Low Premium Bronze Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Low Premium Silver - HMO
    • CareSource Marketplace Low Premium Silver Dental, Vision, & Fitness - HMO
    • CareSource Marketplace Silver - HMO

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

PECOS Enrollment and Medicare Participation Status

Bishoy Hanna 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: 6103189808

    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: I20180411000513

    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

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 08872 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.

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
Advance Care PlanningYesN/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Care Plan 59% 41
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

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. Bishoy Hanna is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
JERSEY CITY MEDICAL CENTER355 GRAND STREET
JERSEY CITY, NJ 7302
(201) 915-2000Acute Care Hospitals
SAINT BARNABAS MEDICAL CENTER94 OLD SHORT HILLS ROAD
LIVINGSTON, NJ 7039
(973) 322-5000Acute 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.
1538507389
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
256810014316
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 6 + 8 + 1 + 0 + 0 + 1 + 4 + 3 + 1 + 6 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1538507389 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538507389, enumerated in the NPI registry as an "individual" on June 13, 2013

The provider is located at 73 Winding Wood Dr Apt 4a Sayreville, Nj 08872 and the phone number is (908) 202-9198

The provider's speciality is Internal Medicine with taxonomy code 207RC0200X with a focus in Critical Care Medicine

The provider has more than 12 years of experience.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas and CareSource. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 16, 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.

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 practitioner is affiliated to the following hospital(s): JERSEY CITY MEDICAL CENTER and SAINT BARNABAS MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 13, 2013. 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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