STANLEY E KRAUS MD
NPI 1720086713
Urology in Framingham, MA

Medicare Participation & PECOS Enrollment Status

Stanley Kraus 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.

Stanley Kraus 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: 3678544111

  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: I20050428000959

  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-Medical/Surgical Supplies (DA000N)

  Lubricant, individual sterile packet, each (HCPCS:A4332)

  3 DME suppliers used 14 Medicare Claims 2640 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF008N)

  Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each (HCPCS:A4351)

  4 DME suppliers used 20 Medicare Claims 3420 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.

Analysis for detection of tumor marker

An analysis for detection of tumor markers is a type of test that identifies specific substances, known as markers, in the body. These markers can indicate the presence of certain types of abnormal growths. This test aids in early detection and monitoring of these growths.

This service was performed 89 times for 61 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 1,238 times for 609 patients

Biopsy of prostate gland

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

This service was performed 23 times for 23 patients

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

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

This service was performed 35 times for 32 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 19 times for 17 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 234 times for 24 patients

Complete ultrasound of penis artery and vein blood flow

This procedure involves using sound waves to create images of your blood vessels. It helps to assess the circulation in the area, identify any blockages or abnormalities, and ensure that blood is flowing properly for optimal health.

This service was performed 20 times for 13 patients

Complete ultrasound scan behind abdominal cavity

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

This service was performed 395 times for 173 patients

Complete ultrasound scan of pelvis

A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.

This service was performed 21 times for 14 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

This service was performed 37 times for 21 patients

Complicated insertion of bladder tube

This procedure involves placing a tube into your bladder to help with urine flow. It may be needed if you have trouble urinating naturally. The process requires specialized skill due to certain complexities but is done with utmost care for your comfort.

This service was performed 64 times for 25 patients

Detection test by nucleic acid for multiple organisms, amplified probe(s) technique

This is a test that identifies various microorganisms in your body using a method called amplified probe technique. It targets specific genetic material (nucleic acids) of the organisms, amplifying them for easy detection. This helps in diagnosing infections accurately.

This service was performed 834 times for 164 patients

Detection test by nucleic acid for organism, amplified probe technique

A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.

This service was performed 3,614 times for 164 patients

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique

A detection test for Staphylococcus aureus uses a method called the amplified probe technique. This method identifies the bacteria's unique genetic material, or nucleic acid, helping to confirm its presence. It's a highly accurate way to detect this type of bacteria.

This service was performed 278 times for 164 patients

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique

A detection test by nucleic acid for Group B Strep uses an amplified probe technique. This test identifies the presence of Group B Strep bacteria in the body. It involves collecting a sample, usually a swab, which is then examined in a lab for the bacteria's genetic material.

This service was performed 26 times for 23 patients

Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique

The detection test by nucleic acid for vancomycin-resistant strep (VRE) is a laboratory procedure. It uses an amplified probe technique to identify specific genetic material in bacteria. This helps determine if the bacteria are resistant to the antibiotic vancomycin.

This service was performed 278 times for 164 patients

Detection test for candida species (yeast), amplified probe technique

This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.

This service was performed 126 times for 23 patients

Diagnostic exam of bladder and urethra using an endoscope

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

This service was performed 124 times for 99 patients

Electronic assessment of bladder emptying

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

This service was performed 80 times for 42 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 136 times for 90 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 1,374 times for 591 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 181 times for 119 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 20 times for 19 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 56 times for 24 patients

Injection procedure to cause erection

This procedure involves administering a medication into your body to stimulate blood flow. It's designed to aid specific physical responses, similar to how adrenaline can increase heart rate. The medication is introduced via a small needle, and the effects typically occur shortly after.

This service was performed 15 times for 14 patients

Injection, garamycin, gentamicin, up to 80 mg

This procedure involves administering an injection of Gentamicin, also known as Garamycin, up to a dose of 80 mg. Gentamicin is an antibiotic used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria.

This service was performed 29 times for 23 patients

Insertion of device into abdomen with pressure and urine flow rate study

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

This service was performed 37 times for 21 patients

Insertion of lower leg neurostimulator electrode

The insertion of a lower leg neurostimulator electrode is a procedure where a small device is placed under your skin. This device sends mild electrical signals to nerves in the lower leg, helping to manage chronic pain. It's a safe, minimally invasive procedure.

This service was performed 128 times for 20 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 669 times for 390 patients

Insertion of temporary bladder tube

This procedure involves placing a small tube into your lower abdomen to help drain urine from your bladder. It's a temporary measure, often used when normal urination is not possible. The tube remains in place until you can urinate on your own again.

This service was performed 65 times for 52 patients

Leuprolide acetate (for depot suspension), 7.5 mg

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

This service was performed 128 times for 21 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 43 times for 43 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 25 times for 25 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

This service was performed 37 times for 21 patients

Prostate resection

Prostate resection is a procedure performed to alleviate discomfort caused by an enlarged prostate. This involves removing a portion of the prostate gland to ease pressure on the urinary tract, improving urine flow and reducing symptoms. It's performed under general or spinal anesthesia.

This service was performed for 1-10 patients

Psa (prostate specific antigen) measurement, free

A PSA measurement, free, is a simple blood test that checks for a specific protein produced by your body. Higher levels may indicate a health concern that needs further investigation. This test is often used to monitor overall wellness.

This service was performed 103 times for 68 patients

Psa (prostate specific antigen) measurement, total

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

This service was performed 615 times for 373 patients

Simple bladder irrigation and/or instillation

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

This service was performed 35 times for 28 patients

Telephone medical discussion with physician, 11-20 minutes

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

This service was performed 16 times for 14 patients

Testosterone (hormone) level, total

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

This service was performed 74 times for 50 patients

Ultrasound measurement of bladder capacity after voiding

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

This service was performed 267 times for 187 patients

Ultrasound scan of pelvic region through rectum

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

This service was performed 69 times for 36 patients

Ultrasound scan of scrotum

An ultrasound scan of the scrotum is a non-invasive imaging test. It uses sound waves to create pictures of the structures within the lower abdominal area. This helps to assess any discomfort or abnormalities you might be experiencing. The procedure is safe and painless.

This service was performed 25 times for 11 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.02 for a new patient copayment and $19.71 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 01701 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.

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. Stanley Kraus is affiliated with the following medical facilities:

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