DR. WILLIAM P ENGLISH MD
NPI 1679579700
Surgery - Vascular Surgery in San Antonio, TX

Medicare Participation & PECOS Enrollment Status

William English 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.

William English 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: 5294704029

  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: I20040929000218

  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.

Blood glucose (sugar) measurement using reagent strip

Blood glucose measurement using a reagent strip is a simple process. A tiny blood sample, usually taken from your finger, is placed on a test strip. The strip is inserted into a device that reads the blood sugar level. It's a quick, easy way to monitor blood sugar levels.

This service was performed 75 times for 69 patients

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

A basic group of blood chemicals test, including calcium and ionized, is a simple procedure where a small amount of blood is drawn from your arm. This test helps assess your body's overall health and detect potential disorders like kidney disease or bone disease.

This service was performed 131 times for 106 patients

Coagulation time measurement, activated

Activated coagulation time measurement is a blood test that checks how long it takes for your blood to clot. It's often used to monitor certain medications and conditions that can affect clotting. The test involves a small blood draw and results are usually quick.

This service was performed 109 times for 83 patients

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 12 times for 12 patients

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.

This service was performed 23 times for 22 patients

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, which is part of the system that cleans your blood when your kidneys can't. A radiologist, a doctor specialized in imaging techniques, will review the process to ensure everything is correct.

This service was performed 35 times for 30 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 150 times for 120 patients

Insertion of tube into chest aorta for diagnosis or treatment with review by radiologist

This procedure involves placing a tube into your chest aorta, a major blood vessel. It's for diagnosis or treatment purposes. A radiologist, a doctor specialized in medical imaging, will review the process to ensure accuracy and safety.

This service was performed 15 times for 14 patients

Insertion of tube into chest artery for diagnosis or treatment with review by radiologist

This procedure involves placing a small tube into a chest artery. It helps diagnose or treat certain heart conditions. A radiologist, a doctor specialized in imaging techniques, will review the results to ensure accuracy and effectiveness.

This service was performed 14 times for 14 patients

Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist

This procedure involves placing a tube into an artery in the brain. It's typically done for diagnostic purposes or treatment. A radiologist, a doctor specializing in imaging, reviews the process to ensure accuracy and safety.

This service was performed 14 times for 14 patients

Leg revascularization (restoring blood flow)

Leg 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 394 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 33,468 times for 170 patients

Red blood cell concentration measurement

Red blood cell concentration measurement is a routine blood test that assesses the number of red blood cells in your blood. These cells carry oxygen throughout your body. The test can help identify conditions like anemia or dehydration. It's a simple, quick, and relatively painless procedure.

This service was performed 132 times for 107 patients

Removal of plaque and insertion of stents in arteries of leg

This procedure, known as angioplasty, involves a small tube being inserted into your leg artery. The tube has a tiny balloon that inflates to remove plaque blocking the artery. A stent (a small mesh tube) is then placed to keep the artery open, improving blood flow.

This service was performed 34 times for 32 patients

Removal of plaque and insertion of stents in artery of leg, initial vessel

This procedure involves clearing blockages in the leg artery caused by plaque buildup. A small tube called a stent is then inserted to keep the artery open, promoting healthy blood flow. This is done for the first affected vessel.

This service was performed 15 times for 13 patients

Removal of plaque in arteries of leg

This 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 23 times for 21 patients

Removal of plaque in artery of leg, each additional vessel

This procedure involves eliminating plaque buildup in your leg arteries to improve blood flow. If more than one vessel is affected, each additional vessel will also be treated in the same session. This can help alleviate symptoms and prevent serious complications.

This service was performed 14 times for 13 patients

Removal of plaque in artery of leg, initial vessel

This procedure involves removing plaque from the initial vessel in your leg. Plaque, a build-up of fat, cholesterol, and other substances, can block blood flow. The removal process, known as an angioplasty, restores healthy blood circulation in your leg.

This service was performed 47 times for 43 patients

Removal of tunneled central venous tube

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

This service was performed 13 times for 13 patients

Review by radiologist of abdominal aorta image

This is a procedure where a radiologist, a doctor specialized in medical imaging, examines an image of your abdominal aorta. The abdominal aorta is the large blood vessel that carries blood to your lower body. The radiologist checks for any abnormalities to ensure your overall vascular health.

This service was performed 95 times for 87 patients

Review by radiologist of arm or leg artery image

This procedure involves a radiologist examining images of your arm or leg arteries. These images are obtained through a non-invasive method, like an ultrasound or CT scan. The radiologist reviews these images to identify any abnormalities, such as blockages or narrowing, which can affect blood flow.

This service was performed 44 times for 41 patients

Review by radiologist of both arms or legs arteries image

This procedure involves a radiologist examining images of your arm or leg arteries. These images help identify any blockages or abnormalities in the blood vessels that could affect circulation. It's a vital step in diagnosing conditions related to blood flow.

This service was performed 66 times for 63 patients

Telephone medical discussion with physician, 5-10 minutes

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

This service was performed 39 times for 34 patients

Ultrasonic guidance for blood vessel access

Ultrasonic 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 46 times for 36 patients

Ultrasound evaluation of blood vessel with review by radiologist, each additional vessel

An 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 183 times for 117 patients

Ultrasound evaluation of blood vessel with review by radiologist, initial vessel

This 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 157 times for 122 patients

Ultrasound of both sides of head and neck blood flow

An 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 25 times for 24 patients

Ultrasound of both sides of head and neck blood flow

An 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 12 times for 12 patients

Ultrasound of one leg arteries or artery grafts

An 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 22 times for 22 patients

Ultrasound study of arm and leg arteries

An 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 12 times for 12 patients

Ultrasound study of arm and leg arteries

An 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 187 times for 145 patients

Ultrasound study of one arm or leg veins with compression and maneuvers

This 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 15 times for 15 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This 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 145 times for 113 patients

Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes

This service involves a physician administering medication to lower your consciousness during a procedure. It's done for your comfort and safety. The drug's effects last about 15 minutes, so additional doses may be given as needed.

This service was performed 128 times for 77 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $17.13 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 78212 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 75.82, 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: 75.82 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: 65.75

  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: 91

  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: 44.48

  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: 44.48

  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.

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