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ILIA SEGAL MD
NPI 1699866871
Internal Medicine - Pulmonary Disease in Union, NJ

Active since September 27, 2006PECOS EnrolledAccepts Medicare Assignment
93.71/100
CMS Quality Rating
2333 MORRIS AVENUE, SUITE A1, UNION, NJ 07083(908) 964-1964(908) 964-6286 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ilia Segal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILIA SEGAL MD (NPI 1699866871) is an individual pulmonary disease provider in Union, New Jersey, licensed in New Jersey (MA39796) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Jersey City Medical Center, and is a graduate of Other (1970).

NPPES Registry Identity

NPI1699866871
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameILIA SEGALCredential: MD
Location Address2333 MORRIS AVENUE, SUITE A1Union, NJ 07083-5746
Mailing Address2333 Morris Avenue, Suite A1Union, NJ 07083-5746 · (908) 964-1964 · Fax (908) 964-6286
Phone(908) 964-1964
Fax(908) 964-6286
Sole ProprietorNo
Medical School CMSOtherGraduated 1970
Enumeration DateSeptember 27, 2006
Last NPPES UpdateApril 9, 2024
NPPES CertifiedApril 9, 2024
✔ NPI 1699866871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NJ · MA39796
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 25MA03979600 (NJ)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 25MA03979600 (NJ), MA39796 (NJ)
2333 MORRIS AVENUE, Union, NJ 07083
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Other Identifiers 1

Medicaid1147901NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ilia Segal Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779593843
PECOS Enrollment IDI20060504000017
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
614 services281 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
302 services230 patients
Test to determine lung volumes using gas dilution or washout 94727
This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.
291 services226 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
291 services226 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
195 services111 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
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.
98 services78 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Jersey City Medical Center

Acute Care Hospitals · Jersey City, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310074
Location355 Grand StreetJersey City, NJ 07302 · Hudson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07083 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.79
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
93%255 patients4/55-star benchmark: 100%
Medication Reconciliation
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.
83%24 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
43%60 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
11%90 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 88% · 50 patients
88%50 patients
Provide Patient Access
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…
38%60 patients2/55-star benchmark: 100%
Secure Messaging
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…
2%60 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 84 patients
0%84 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 22

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
8 suppliers18 claims18 services$30.55 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers18 claims18 services$68.89 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers18 claims53 services$28.14 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers15 claims90 services$14.87 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
8 suppliers25 claims25 services$43.25 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
9 suppliers28 claims28 services$14.21 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PULMONARY & CRITICAL CARE ASSOCIATES,LLC
Internal Medicine (Pulmonary Disease)
2333 MORRIS AVENUE, SUITE A1
UNION, NJ 07083
Union County (908) 964-1964
JESSE KARPMAN MD
Internal Medicine (Pulmonary Disease)
2333 MORRIS AVENUE, SUITE A1
UNION, NJ 07083
Union County (908) 964-1964

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ilia Segal's NPI number?

The NPI number for Ilia Segal is 1699866871. It was assigned to this individual provider in the NPPES registry on September 27, 2006.

Where is Ilia Segal located?

Ilia Segal practices at 2333 Morris Avenue Suite A1, Union, NJ 07083. The listed phone number is (908) 964-1964.

What is Ilia Segal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Ilia Segal enrolled in Medicare?

Yes. Ilia Segal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ilia Segal accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Ilia Segal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ilia Segal affiliated with any hospitals?

According to CMS data, Ilia Segal is affiliated with Jersey City Medical Center.

When was this NPI record last updated?

The NPPES record for Ilia Segal was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.