WALLACE GLADDEN
NPI 1689803827
Physical Medicine & Rehabilitation in Albuquerque, NM

Medicare Participation & PECOS Enrollment Status

Wallace Gladden 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.

Wallace Gladden 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: 9638321409

  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: I20171128002840

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Other DME (DE000N)

  Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)

  3 DME suppliers used 14 Medicare Claims 14 Services Paid

• DME-Hospital Beds (DB000N)

  Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

  3 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

  5 DME suppliers used 25 Medicare Claims 25 Services Paid

• DME-Other DME (DE000N)

  Respiratory suction pump, home model, portable or stationary, electric (HCPCS:E0600)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  5 DME suppliers used 25 Medicare Claims 25 Services Paid

• DME-Wheelchairs (DD021N)

  General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)

  2 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  7 DME suppliers used 152 Medicare Claims 152 Services Paid

• DME-Wheelchairs (DD000N)

  Lightweight wheelchair (HCPCS:K0003)

  2 DME suppliers used 49 Medicare Claims 49 Services Paid

• DME-Wheelchairs (DD000N)

  High strength, lightweight wheelchair (HCPCS:K0004)

  1 DME suppliers used 12 Medicare Claims 12 Services Paid

• DME-Wheelchairs (DD021N)

  Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)

  4 DME suppliers used 68 Medicare Claims 68 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF003N)

  Below knee, molded socket, shin, sach foot, endoskeletal system (HCPCS:L5301)

  5 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, test socket, below knee (HCPCS:L5620)

  5 DME suppliers used 35 Medicare Claims 46 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, acrylic socket (HCPCS:L5629)

  5 DME suppliers used 31 Medicare Claims 32 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, total contact (HCPCS:L5637)

  5 DME suppliers used 35 Medicare Claims 35 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee, flexible inner socket, external frame (HCPCS:L5645)

  5 DME suppliers used 26 Medicare Claims 26 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee suction socket (HCPCS:L5647)

  5 DME suppliers used 15 Medicare Claims 15 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert (HCPCS:L5671)

  6 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism (HCPCS:L5673)

  6 DME suppliers used 23 Medicare Claims 48 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism (HCPCS:L5679)

  5 DME suppliers used 30 Medicare Claims 55 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each (HCPCS:L5685)

  5 DME suppliers used 25 Medicare Claims 49 Services Paid

• DME-Orthotic Devices (DF003N)

  Replacement, socket, below knee, molded to patient model (HCPCS:L5700)

  5 DME suppliers used 14 Medicare Claims 14 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, alignable system (HCPCS:L5910)

  5 DME suppliers used 23 Medicare Claims 24 Services Paid

• DME-Orthotic Devices (DF003N)

  Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) (HCPCS:L5940)

  5 DME suppliers used 30 Medicare Claims 31 Services Paid

• DME-Orthotic Devices (DF003N)

  Prosthetic sock, multiple ply, below knee, each (HCPCS:L8420)

  5 DME suppliers used 32 Medicare Claims 232 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic shrinker, below knee, each (HCPCS:L8440)

  5 DME suppliers used 15 Medicare Claims 30 Services Paid

• DME-Orthotic Devices (DF000N)

  Prosthetic sock, single ply, fitting, below knee, each (HCPCS:L8470)

  5 DME suppliers used 28 Medicare Claims 170 Services Paid

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 11 times for 11 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 34 times for 29 patients

Established patient office or other outpatient visit, 40-54 minutes

This 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 57 times for 34 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 351 times for 142 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 573 times for 144 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 31 times for 27 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 81 times for 79 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial 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 38 times for 38 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial 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 52 times for 51 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 18 times for 18 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Wallace Gladden is affiliated with the following medical facilities:

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