DR. DAVID CHARLES GUTMAN M.D.
NPI 1710248273
Radiology - Neuroradiology in Philadelphia, PA

Medicare Participation & PECOS Enrollment Status

David Gutman 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.

David Gutman 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: 5890040729

  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: I20190812002428, I20200108000356

  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.

3d radiographic procedure with computerized image postprocessing

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

This service was performed 48 times for 48 patients

3d radiographic procedure with computerized image postprocessing

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

This service was performed 78 times for 75 patients

Administration of chemotherapy into fluid-filled space between the tissue that cover the brain and spinal cord

This procedure involves giving chemotherapy into the space filled with fluid that surrounds the brain and spinal cord. It's a targeted approach to destroy cancer cells in this area. A needle is inserted to deliver the medication.

This service was performed 21 times for 17 patients

Ct scan head or brain without contrast

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

This service was performed 103 times for 95 patients

Ct scan head or brain without contrast

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

This service was performed 27 times for 27 patients

Ct scan of head or brain before and after contrast

A CT scan of the head or brain uses special X-ray equipment to create detailed images of your brain's structure. Before and after contrast means two scans are done. Initially, images are taken without a contrast dye. Then, a dye is given to highlight certain areas, providing a clearer picture.

This service was performed 19 times for 19 patients

Ct scan of lower spine with contrast

A CT scan of the lower spine with contrast is a non-invasive imaging test that uses X-ray technology and a contrast dye to create detailed pictures of your lower spine. It helps in diagnosing conditions like herniated discs, fractures, or tumors.

This service was performed 17 times for 17 patients

Ct scan of middle spine with contrast

A CT scan of the middle spine with contrast is a detailed imaging test. A special dye is used to highlight areas in your spine, providing clearer pictures. It helps doctors diagnose issues such as injuries, infections, or diseases in that area.

This service was performed 12 times for 12 patients

Ct scan of soft tissue of neck with contrast

A CT scan of the neck with contrast is a non-invasive imaging procedure. A special dye is administered to highlight the soft tissues in your neck, making them easier to see. This helps detect issues like infections, tumors, or other abnormalities.

This service was performed 31 times for 31 patients

Ct scan of soft tissue of neck with contrast

A CT scan of the neck with contrast is a non-invasive imaging procedure. A special dye is administered to highlight the soft tissues in your neck, making them easier to see. This helps detect issues like infections, tumors, or other abnormalities.

This service was performed 61 times for 60 patients

Ct scan of soft tissue of neck without contrast

A CT scan of the neck's soft tissue without contrast is a non-invasive imaging technique. It uses X-rays to create detailed pictures of your neck area, helping to identify issues like infections, injuries, or tumors. No special dye (contrast) is used in this procedure.

This service was performed 11 times for 11 patients

Fluoroscopic guidance for spine or back muscle injection

Fluoroscopic guidance for spine or back muscle injection is a procedure where a special X-ray technology, called fluoroscopy, is used to help accurately place the needle for an injection in the spine or back muscles. This ensures precise delivery of medication to the targeted area.

This service was performed 21 times for 17 patients

Mri scan of bone of eye socket, face, and/or neck before and after contrast

An MRI scan of the eye socket, face, and/or neck uses magnetic fields to create detailed images of these areas. Contrast dye helps highlight specific tissues for clearer pictures. It's non-invasive, aids in detecting abnormalities, and guides treatment plans.

This service was performed 13 times for 13 patients

Mri scan of bone of eye socket, face, and/or neck before and after contrast

An MRI scan of the eye socket, face, and/or neck uses magnetic fields to create detailed images of these areas. Contrast dye helps highlight specific tissues for clearer pictures. It's non-invasive, aids in detecting abnormalities, and guides treatment plans.

This service was performed 23 times for 22 patients

Mri scan of brain before and after contrast

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

This service was performed 116 times for 116 patients

Mri scan of brain before and after contrast

An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.

This service was performed 276 times for 266 patients

Mri scan of brain without contrast

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

This service was performed 12 times for 12 patients

Mri scan of lower spinal canal before and after contrast

An MRI scan of the lower spinal canal with contrast is a non-invasive imaging procedure. It uses magnetic fields to generate detailed images of your lower spine. A contrast agent is injected to enhance these images, helping doctors see issues more clearly.

This service was performed 39 times for 38 patients

Mri scan of lower spinal canal before and after contrast

An MRI scan of the lower spinal canal with contrast is a non-invasive imaging procedure. It uses magnetic fields to generate detailed images of your lower spine. A contrast agent is injected to enhance these images, helping doctors see issues more clearly.

This service was performed 51 times for 50 patients

Mri scan of middle spinal canal before and after contrast

An MRI scan of the middle spinal canal with contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your spine, both before and after a contrast dye is injected. The dye helps to highlight certain structures, providing a clearer picture for diagnosis.

This service was performed 37 times for 36 patients

Mri scan of middle spinal canal before and after contrast

An MRI scan of the middle spinal canal with contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your spine, both before and after a contrast dye is injected. The dye helps to highlight certain structures, providing a clearer picture for diagnosis.

This service was performed 46 times for 45 patients

Mri scan of upper spinal canal before and after contrast

An MRI scan of the upper spinal canal before and after contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. Contrast dye is injected to enhance these images, providing clearer visuals for accurate diagnosis.

This service was performed 34 times for 33 patients

Mri scan of upper spinal canal before and after contrast

An MRI scan of the upper spinal canal before and after contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. Contrast dye is injected to enhance these images, providing clearer visuals for accurate diagnosis.

This service was performed 39 times for 39 patients

Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance

A lower back spinal tap, guided by imaging, is a procedure to collect spinal fluid for testing. A needle is carefully inserted into the lower back to draw out fluid. This can help diagnose various conditions. It's performed under local anesthesia to minimize discomfort.

This service was performed 44 times for 44 patients

X-ray of multiple regions of spinal canal with review by radiologist

This is a diagnostic procedure where images of various sections of your spinal canal are captured using X-rays. A radiologist, a doctor specializing in medical imaging, will review these pictures to identify any abnormalities.

This service was performed 16 times for 16 patients

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 85.46, 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: 85.46 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: 80.05

  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: 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: 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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