TIM M ZHENG MD
NPI 1639252182
Pathology - Anatomic Pathology & Clinical Pathology in Oaks, PA

Medicare Participation & PECOS Enrollment Status

Tim Zheng 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.

Tim Zheng 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: 7810056512

  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: I20081111000099

  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.

Analysis for antibody, treponema pallidum

The analysis for the antibody, Treponema pallidum, is a blood test used to detect a specific bacteria that may be in your system. This bacteria is commonly associated with certain health conditions. The test helps your doctor plan the best treatment for you.

This service was performed 40 times for 39 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 1,004 times for 851 patients

Bacterial colony count, urine

A bacterial colony count, urine, is a laboratory test that checks a urine sample for bacteria. It helps to identify if an infection is present in the urinary system. High numbers of bacteria in the urine can indicate a urinary tract infection (UTI).

This service was performed 2,083 times for 1,727 patients

Blood creatinine level

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

This service was performed 12 times for 11 patients

Blood group typing (abo)

Blood group typing, or ABO typing, is a test that identifies your blood type. This is vital information for blood transfusions or organ transplants to ensure compatibility. The test involves analyzing your blood for certain antibodies and antigens.

This service was performed 20 times for 19 patients

Blood test, basic group of blood chemicals (calcium, total)

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

This service was performed 16 times for 16 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 71 times for 69 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 51 times for 51 patients

Blood typing for rh (d) antigen

Blood typing for Rh (D) antigen is a test that identifies if you have a specific protein, the RhD antigen, on your blood cells. If present, you are Rh positive. If absent, you are Rh negative. This information is crucial for safe blood transfusions and pregnancy care.

This service was performed 19 times for 18 patients

Calcium level, total

A total calcium level test measures the amount of calcium in your blood. Calcium is essential for body functions like bone formation, nerve signal transmission, and muscle contraction. Abnormal levels may indicate conditions like bone disease or kidney disorders.

This service was performed 28 times for 27 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

This service was performed 73 times for 70 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 44 times for 41 patients

Detection test by immunoassay technique for hepatitis b surface antigen

This test helps identify the presence of hepatitis B in your body. It uses an immunoassay technique, which is a highly sensitive method that detects the hepatitis B surface antigen, a protein on the virus. This test can help diagnose an active infection or determine if you're a carrier.

This service was performed 36 times for 36 patients

Detection test by immunoassay technique for hiv-1 antigen and hiv-1 and hiv-2 antibodies

This is a test that checks for proteins (antigens) of HIV-1 and antibodies to both HIV-1 and HIV-2 in your blood. These elements appear when your body responds to the HIV virus. It's a vital method for early HIV detection and helps manage your health.

This service was performed 58 times for 53 patients

Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique

A detection test by nucleic acid for chlamydia trachomatis, amplified probe technique, is a test that identifies the presence of a specific bacteria in the body. This bacteria can cause various health issues. The technique amplifies the sample to improve accuracy.

This service was performed 304 times for 280 patients

Detection test by nucleic acid for herpes simplex virus, amplified probe technique

This test uses an amplified probe technique to identify the presence of the herpes simplex virus in your body. It works by detecting the virus's genetic material, or nucleic acid. The test is accurate, reliable, and can help in early detection and treatment.

This service was performed 228 times for 110 patients

Detection test by nucleic acid for human papillomavirus (hpv), high-risk types

This test detects high-risk types of HPV, a common virus. It's done by analyzing a small sample of cells for the presence of HPV DNA. The aim is to identify any high-risk types early, as they may increase the risk of certain health issues.

This service was performed 3,283 times for 3,233 patients

Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique

This is a lab test that checks for the presence of a specific bacteria called Neisseria gonorrhoeae in your body. It uses a technique called amplified probe, which makes many copies of the bacteria's genetic material (nucleic acid) to help detect it more easily.

This service was performed 303 times for 279 patients

Detection test by nucleic acid for trichomonas vaginalis (genital parasite), amplified probe technique

This is a test to identify a common microscopic organism that can cause discomfort. The technique involves using a special probe to amplify the organism's genetic material, making it easier to detect. It's a simple, safe, and accurate procedure.

This service was performed 286 times for 271 patients

Detection test by nucleic acid for trichomonas vaginalis (genital parasite), direct probe technique

This test helps identify a common microscopic organism that can cause discomfort. It uses a direct probe technique, which involves analyzing a small sample from your body. The test detects the organism's unique genetic material (nucleic acid), confirming its presence.

This service was performed 989 times for 835 patients

Detection test for candida species (yeast), amplified probe technique

This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.

This service was performed 602 times for 546 patients

Detection test for candida species (yeast), direct probe technique

The detection test for Candida species uses a direct probe technique. This is a lab test where a sample is taken from your body, typically from the mouth or skin. The sample is then examined under a microscope to identify the presence of Candida, a type of yeast that can cause infection.

This service was performed 989 times for 835 patients

Detection test for gardnerella vaginalis (bacteria), direct probe technique

This test helps find a certain type of bacteria called Gardnerella vaginalis. The direct probe technique uses a small sample from your body. This sample is then examined in a lab to see if this bacteria is present. This helps in identifying and treating any related health issues.

This service was performed 988 times for 835 patients

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral)

Evaluation of antimicrobial drugs involves testing how effective these medicines are in stopping harmful microorganisms. This can include bacteria (antibiotics), fungi (antifungals), or viruses (antivirals). The goal is to ensure the right medicine is used for your condition.

This service was performed 731 times for 624 patients

Gonadotropin, follicle stimulating (reproductive hormone) level

This is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.

This service was performed 56 times for 55 patients

Gonadotropin, luteinizing (reproductive hormone) level

This is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.

This service was performed 25 times for 25 patients

Hemoglobin a1c level

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

This service was performed 11 times for 11 patients

Hepatitis c antibody measurement

Hepatitis C antibody measurement is a blood test to check if you have been exposed to the Hepatitis C virus. This virus affects your liver. If the test is positive, it means you have had the virus at some point. Additional tests are needed to determine if the virus is currently active.

This service was performed 52 times for 49 patients

Identification of organisms by immunologic analysis, other than immunofluorescence method

Immunologic analysis is a test that helps identify specific organisms causing an infection. This method uses your body's immune response to detect these organisms. It's different from the immunofluorescence method, but still provides accurate results. It's a key step in ensuring proper treatment.

This service was performed 45 times for 41 patients

Immunologic analysis for detection of tumor antigen, quantitative; ca 125

This test checks for CA 125, a protein often found in higher amounts in individuals with certain types of tumors. It involves analyzing a blood sample in a lab. It's a quantitative test, meaning it measures the level of CA 125 in your blood.

This service was performed 23 times for 23 patients

Manual urinalysis test with examination using microscope, non-automated

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

This service was performed 148 times for 136 patients

Measurement of rna of bacteria in vaginal fluid specimen

This is a lab test where a small sample of fluid is collected from the female body's lower region. The test measures the RNA (genetic material) of bacteria in the sample. This helps doctors understand the types and amounts of bacteria present, aiding in diagnosis and treatment.

This service was performed 588 times for 537 patients

Measurement of total estradiol (hormone)

Total estradiol measurement is a simple blood test that examines the level of a key hormone in your body. This hormone plays a vital role in many body functions. The test helps understand if hormone levels are balanced, which can impact overall health.

This service was performed 50 times for 49 patients

Pap test

A Pap test is a routine exam that checks for changes in cells that could signal a health concern. During this test, a small sample of cells is gently collected from the lower region of the body. The sample is then examined under a microscope to ensure everything looks normal.

This service was performed 49 times for 49 patients

Pap test, automated thin layer preparation; automated system and manual rescreening

A Pap test is a screening tool that helps detect unusual cells. The automated thin layer preparation involves placing your cell sample in a thin layer on a slide. An automated system then scans the slide, and experts manually review any areas flagged by the system. This method enhances the accuracy of the results.

This service was performed 94 times for 92 patients

Pap test, manual screening

A Pap test is a routine procedure that checks for unusual changes in cells. During the manual screening, a small sample of cells is gently collected from the lower region of the body. These cells are then examined under a microscope to ensure your health.

This service was performed 362 times for 360 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 1,124 times for 846 patients

Pathology examination of tissue using a microscope, moderately high complexity

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

This service was performed 12 times for 12 patients

Progesterone (reproductive hormone) level

A progesterone level test measures the amount of progesterone, a hormone, in your body. It plays a key role in preparing the body for pregnancy and maintaining it. The test can help assess overall hormonal health and aid in diagnosing certain conditions.

This service was performed 16 times for 15 patients

Prolactin (milk producing hormone) level

A prolactin level test measures the amount of a hormone, prolactin, in your blood. This hormone plays a role in many bodily functions, such as the creation of milk. High or low levels can indicate certain health conditions. The test involves a simple blood draw.

This service was performed 22 times for 22 patients

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician

This is a routine health check where a sample of cells is collected from the lower region of the female reproductive system. The sample is preserved and prepared using automated technology for detailed examination. A doctor interprets the results to check for any abnormalities.

This service was performed 804 times for 778 patients

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision

This is a routine screening procedure where cells are collected from the lower female tract. The cells are placed in a special fluid, prepared in a thin layer for microscopic examination. This is done under the supervision of a medical professional to ensure accuracy.

This service was performed 8,653 times for 8,653 patients

Screening test for red blood cell antibodies

A screening test for red blood cell antibodies is a simple blood test to identify if your body has produced proteins that may react against certain types of blood. These proteins can cause complications in certain situations like transfusions or pregnancy.

This service was performed 20 times for 19 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 315 times for 194 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 365 times for 307 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 62 times for 58 patients

Testosterone (hormone) level, free

A free testosterone level test measures the amount of unattached, or "free," testosterone in your blood. Testosterone is a hormone that's important for certain body functions. This test is used to check if your hormone level is in the normal range.

This service was performed 18 times for 17 patients

Testosterone (hormone) level, total

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

This service was performed 18 times for 17 patients

Thyroxine (thyroid chemical), free

The Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.

This service was performed 21 times for 21 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 70 times for 69 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 $26.3 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 19456 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.

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 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 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: 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: N/A

  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: 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: N/A

  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.

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