DR. CARLOS ALBERTO NEVES M.D.
NPI 1558521567
Surgery - Vascular Surgery in Lewes, DE
Quality Rating: 87.45 out of 100 score
NPI Status: Active since June 12, 2008
Contact Information
33664 BAYVIEW MEDICAL DR
UNIT 2
LEWES, DE
ZIP 19958
Phone: (302) 644-4954
Fax: (302) 645-5481
- Individual
- Male
- Years of Experience 18
- Surgery
- Vascular Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About CARLOS NEVES
This page provides the complete NPI Profile along with additional information for Carlos Neves, a provider established in Lewes, Delaware with a medical specialization in Surgery, focusing in vascular surgery and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1558521567 assigned on June 2008. The practitioner's primary taxonomy code is 2086S0129X with license number C1-0011347 (DE). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1558521567
- Provider Name
- DR. CARLOS ALBERTO NEVES M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 33664 BAYVIEW MEDICAL DR UNIT 2 LEWES, DE 19958
- Location Phone
- (302) 644-4954
- Location Fax
- (302) 645-5481
- Mailing Address
- 501 GOLF TERRACE UNION, NJ 07083
- Mailing Phone
- (908) 868-4895
- Medical School Name
- OTHER
- Graduation Year
- 2008
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-12-2008
- Last Update Date
- 08-04-2015
- Code Navigator
Location Map
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
Surgery Vascular Surgery
- Taxonomy Code
- 2086S0129X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- C1-0011347
- License State
- DE
- Taxonomy Description
- A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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) |
---|---|---|---|---|
1 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | MT193766 (PA) |
2 | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | 25MA09298000 (NJ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Premier Silver - EPO
- Premier Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Central Bronze - HMO
- Central Bronze + Vision + Adult Dental - HMO
- Central Gold - HMO
- Central Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Deluxe + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- my Blue Access Major Events PPO Catastrophic 9200 - 3 Free PCP Visits - PPO
- my Blue Access PPO Bronze 3800 - PPO
- my Blue Access PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access PPO Bronze 7400 HSA - Custom Drug Benefit - PPO
- my Blue Access PPO Bronze 8900 - PPO
- my Blue Access PPO Gold 0 - PPO
- my Blue Access PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access PPO Gold 1700 HSA - PPO
- my Blue Access PPO Premier Gold 0 - PPO
- my Blue Access PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access PPO Premier Platinum 0 - PPO
- my Blue Access PPO Premier Platinum 0 + Adult Dental and Vision - PPO
- my Blue Access PPO Silver 7000 - PPO
- my Blue Access PPO Standard Bronze 7500 - PPO
- my Blue Access PPO Standard Gold 1500 - PPO
- my Blue Access PPO Standard Platinum 0 - PPO
- my Blue Access PPO Standard Silver 5000 - PPO
- my Blue Access PPO Standard Silver 5000 + Adult Dental and Vision - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Carlos Neves 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.
Carlos Neves 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: 1658686860
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: I20150818003854
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.
Chemical destruction of first incompetent vein of arm or leg using imaging guidance
Complete ultrasound of abdomen and pelvis artery and vein blood flow
Complete ultrasound of abdomen and pelvis artery and vein blood flow
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Complete ultrasound study of arm and leg arteries
Complete ultrasound study of arm and leg arteries
Destruction of first incompetent vein of arm or leg using radiofrequency and imaging guidance
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection of chemical agent into single incompetent vein of leg using ultrasound guidance
Insertion of stent and blood clot protection device in neck artery with review by radiologist
Leg revascularization (restoring blood flow)
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of plaque in arteries of leg
Telephone medical discussion with physician, 11-20 minutes
Ultrasonic guidance for blood vessel access
Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel
Ultrasound evaluation of blood vessel with review by radiologist, initial vessel
Ultrasound of both sides of head and neck blood flow
Ultrasound of both sides of head and neck blood flow
Ultrasound of hemodialysis access
Ultrasound of leg arteries or artery grafts
Ultrasound of leg arteries or artery grafts
Ultrasound of one leg arteries or artery grafts
Ultrasound study of arm and leg arteries
Ultrasound study of arm and leg arteries
Ultrasound study of arm or leg veins with compression and maneuvers
Ultrasound study of arm or leg veins with compression and maneuvers
Ultrasound study of one arm or leg veins with compression and maneuvers
Ultrasound study of one arm or leg veins with compression and maneuvers
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
Varicose vein removal
This procedure involves using a chemical to close off a malfunctioning vein in your arm or leg. Imaging guidance is used to accurately locate the vein. This helps improve blood flow by rerouting it through healthier veins.
This service was performed 13 times for 13 patientsThis procedure uses sound waves to create images of your abdomen and pelvis, specifically focusing on the arteries and veins. It helps in assessing the blood flow and detecting any abnormalities, ensuring your overall well-being.
This service was performed 35 times for 35 patientsThis procedure uses sound waves to create images of your abdomen and pelvis, specifically focusing on the arteries and veins. It helps in assessing the blood flow and detecting any abnormalities, ensuring your overall well-being.
This service was performed 11 times for 11 patientsThis procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.
This service was performed 15 times for 15 patientsThis procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.
This service was performed 71 times for 70 patientsThis procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.
This service was performed 89 times for 89 patientsThis procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.
This service was performed 34 times for 30 patientsThis procedure involves using radiofrequency energy, a type of heat energy, to close off an unhealthy vein in your arm or leg. Imaging guidance helps ensure precise targeting of the vein. This helps improve blood flow by rerouting it through healthier veins.
This service was performed 30 times for 21 patientsThis 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 14 times for 11 patientsThis 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 350 times for 243 patientsThis 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 351 times for 306 patientsThis 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 18 times for 18 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 39 times for 37 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 16 times for 16 patientsThis procedure involves injecting a chemical agent into a non-functioning vein in your leg. Ultrasound technology is used to accurately locate the vein. The chemical helps to close off the vein, rerouting blood flow to healthier veins.
This service was performed 36 times for 26 patientsThis procedure involves placing a small mesh tube, or stent, in your neck artery to ensure blood flow. A protective device is also inserted to prevent blood clots from reaching the brain. A radiologist reviews the procedure to ensure everything is in place correctly.
This service was performed 11 times for 11 patientsLeg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.
This service was performed for 66 patientsThis 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 162 times for 162 patientsThis 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 37 times for 37 patientsThis procedure, known as atherectomy, involves clearing out plaque buildup in the leg arteries. Plaque can restrict blood flow, causing discomfort and potential health issues. A special device is inserted into the artery to carefully remove the plaque, improving blood circulation.
This service was performed 14 times for 13 patientsThis is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
This service was performed 12 times for 12 patientsUltrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.
This service was performed 68 times for 59 patientsAn ultrasound evaluation of a blood vessel is a non-invasive procedure that uses sound waves to create images of your blood vessels. A radiologist reviews these images to check for any abnormalities. If additional vessels need reviewing, the process is repeated.
This service was performed 32 times for 29 patientsThis procedure involves using ultrasound, a safe imaging technique, to examine your blood vessels. The images are then reviewed by a radiologist, a doctor specialized in medical imaging. The process helps identify any abnormalities in your initial vessel.
This service was performed 49 times for 42 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 306 times for 303 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 133 times for 129 patientsAn ultrasound of hemodialysis access is a non-invasive procedure that uses sound waves to create images of your dialysis access site. It helps monitor the access site's health and detect any potential issues like blockages or narrowing.
This service was performed 15 times for 13 patientsAn ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.
This service was performed 26 times for 25 patientsAn ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.
This service was performed 27 times for 27 patientsAn ultrasound of leg arteries or artery grafts is a non-invasive test using sound waves to create images of your blood vessels. This helps doctors assess blood flow, identify blockages, and monitor the health of grafts.
This service was performed 30 times for 30 patientsAn ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
This service was performed 95 times for 87 patientsAn ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
This service was performed 109 times for 109 patientsAn ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.
This service was performed 269 times for 259 patientsAn ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.
This service was performed 61 times for 61 patientsThis is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.
This service was performed 416 times for 399 patientsThis is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.
This service was performed 81 times for 74 patientsThis procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
This service was performed 70 times for 60 patientsVaricose 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 101 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.09 for a new patient copayment and $17.79 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 19958 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $88.37
- Minimum New Patient Price $57.12
- Maximum New Patient Price $173.08
- Average New Patient Copayment $22.09
- Minimum New Patient Copayment $14.28
- Maximum New Patient Copayment $43.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $71.19
- Minimum Established Patient Price $18.36
- Maximum Established Patient Price $141.05
- Average Established Patient Copayment $17.79
- Minimum Established Patient Copayment $4.59
- Maximum Established Patient Copayment $35.26
* 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 87.45, 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.
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Final Score: 87.45 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.
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Quality Score: 97.93
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.
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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: 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: 60.92
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: 60.92
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 provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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 |
---|---|---|
Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
Health Information Exchange | 6% | 232 |
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
Implementation of medication management practice improvements | Yes | N/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 Level | Yes | N/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. | ||
Medication Reconciliation | 100% | 170 |
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 | 49% | 594 |
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 | 92% | 594 |
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 | 14% | 594 |
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 Analysis | Yes | N/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. | ||
Specialized Registry Reporting | Yes | N/A |
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
Use of decision support and standardized treatment protocols | Yes | N/A |
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. |
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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. | |||||||||
1 | 5 | 5 | 8 | 5 | 2 | 1 | 5 | 6 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 5 | 10 | 8 | 10 | 2 | 2 | 5 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 5 + 1 + 0 + 8 + 1 + 0 + 2 + 2 + 5 + 1 + 2 + 24 = 53 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 53 = 7 | 7 |
The NPI number 1558521567 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
DR. MAYER M KATZ MD
Surgery
(Vascular Surgery)
33664 BAYVIEW MEDICAL DR
UNIT 2
LEWES, DE
ZIP 19958
KATHLEEN G CANNATELLI FNP
Nurse Practitioner
(Family)
33664 BAYVIEW MEDICAL DR
SUITE 2
LEWES, DE
ZIP 19958
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1558521567, enumerated as an "individual" on June 12, 2008.
The provider is located at 33664 BAYVIEW MEDICAL DR UNIT 2 LEWES, DE 19958 and the phone number is (302) 644-4954.
Surgery with taxonomy code 2086S0129X and a focus in Vascular Surgery.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Home State Health,. Please consult your insurance carrier or call the provider to verify.