DONALD GARY WOLFORD DDS
NPI 1659355063
Oral & Maxillofacial Surgery in St Clair Shores, MI

Medicare Participation & PECOS Enrollment Status

Donald Wolford 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.

Donald Wolford 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) and a Home Health Agency (HHA).

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: 840487690

  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: I20101207000249

  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: No

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.

Established patient office or other outpatient visit, 20-29 minutes

This 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 24 times for 14 patients

Established patient office or other outpatient visit, 30-39 minutes

This 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 22 times for 17 patients

Imaging of jaws and skull

Imaging of jaws and skull involves taking detailed pictures of these areas to help diagnose and treat various conditions. This can include X-rays, CT scans, or MRI scans. These images allow doctors to view the bone structure, tissues, and any abnormalities present. It's a safe and painless process.

This service was performed 17 times for 15 patients

New patient office or other outpatient visit, 45-59 minutes

This 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 11 times for 11 patients

X-ray of body plane

An X-ray of a body plane is a non-invasive imaging test that helps visualize the inside of your body. It uses a small amount of radiation to produce images of structures within your body, such as bones and organs. This procedure aids in diagnosing, monitoring, and treating various medical conditions.

This service was performed 23 times for 21 patients

X-ray of face bones, 1-2 views

An X-ray of face bones, with 1-2 views, is a simple, quick imaging test. It uses a small amount of radiation to produce images of the bones in your face. This test can help detect fractures, infections, or other abnormalities. It's painless and non-invasive.

This service was performed 17 times for 15 patients

X-ray of jaw joints on both sides of mouth

An X-ray of jaw joints on both sides of the mouth, also known as a TMJ X-ray, helps visualize the structure and condition of your jaw joints. This non-invasive procedure involves capturing images using a small amount of radiation. It aids in diagnosing issues like arthritis, dislocation, or other abnormalities in the jaw area.

This service was performed 13 times for 12 patients

X-ray of lower jaws, upper jaws and teeth

An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.

This service was performed 18 times for 16 patients

X-ray of skull, 1-3 views

An X-ray of the skull involves capturing images of the bones and tissues in your head. This test helps identify issues like fractures, infections, or tumors. The '1-3 views' means pictures will be taken from one to three different angles for a comprehensive assessment.

This service was performed 17 times for 15 patients

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