DR. TYLER AARON GONZALEZ M.D., M.B.A.
NPI 1750644290
Orthopaedic Surgery - Foot and Ankle Surgery in Columbia, SC

Medicare Participation & PECOS Enrollment Status

Tyler Gonzalez 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.

Tyler Gonzalez 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: 1850546433

  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: I20200109001886

  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-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  2 DME suppliers used 16 Medicare Claims 16 Services Paid

• DME-Wheelchairs (DD021N)

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

  2 DME suppliers used 16 Medicare Claims 16 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF003N)

  Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf (HCPCS:L1902)

  3 DME suppliers used 13 Medicare Claims 13 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.

Amputation of toe at joint between forefoot and toes

Amputation of a toe at the joint between forefoot and toes is a surgical procedure performed to remove a toe due to severe injury, infection, or disease. It aims to alleviate pain, prevent disease spread, and improve overall foot function.

This service was performed 13 times for 11 patients

Application of short leg cast

The application of a short leg cast is a procedure to stabilize and support the lower leg or foot after an injury. A special material is wrapped around the leg, hardening to form a protective shell. This helps to keep the bones in place, reduce pain, and promote healing.

This service was performed 33 times for 24 patients

Aspiration and/or injection of fluid from medium joint using ultrasound guidance

This is a procedure where a needle is guided by ultrasound into a medium-sized joint, like a knee or shoulder. The needle can be used to remove fluid, which can relieve pressure and pain, or to inject medication to help with inflammation and discomfort.

This service was performed 29 times for 20 patients

Aspiration and/or injection of fluid from small joint using ultrasound guidance

This procedure involves using ultrasound to accurately locate a small joint. A needle is then carefully inserted to remove fluid (aspiration) or inject medication. This can help diagnose or treat joint issues. It's generally safe and minimally invasive.

This service was performed 25 times for 13 patients

Cast supplies, short leg cast, adult (11 years +), fiberglass

A short leg cast, made of fiberglass, is used for adults and children aged 11 and up. It's a supportive structure for the lower leg, often used when a bone is broken. The fiberglass material is lightweight, durable, and can be molded to fit your leg comfortably.

This service was performed 42 times for 28 patients

Ct scan of leg without contrast

A CT scan of the leg is a non-invasive imaging test that uses X-rays to capture detailed images of your leg's bones, muscles, and blood vessels. It doesn't use contrast dye and doesn't cause any pain. It helps in diagnosing injuries or diseases.

This service was performed 22 times for 19 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more

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 86 times for 72 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

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 123 times for 90 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

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 111 times for 94 patients

Incision of foot bone

An incision of the foot bone, also known as an osteotomy, is a surgical procedure where a bone in your foot is cut to correct its alignment or length. This can help alleviate pain and improve function. Rest and rehabilitation will be needed post-surgery.

This service was performed 18 times for 11 patients

Incision of toe joint capsule

An incision of the toe joint capsule is a surgical procedure where a small cut is made to access the joint capsule in your toe. This can help to relieve pain or pressure, correct deformities, or treat certain conditions. Your doctor will discuss the details and potential benefits with you.

This service was performed 50 times for 18 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 31 times for 15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

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 11 times for 11 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 18 times for 15 patients

Repair of multiple toe tendons

The repair of multiple toe tendons is a surgery aimed at mending damaged tendons in your toes. This procedure helps restore normal toe function, improve mobility, and alleviate pain. It's typically carried out under anesthesia. Recovery may involve physical therapy.

This service was performed 43 times for 16 patients

X-ray of ankle, minimum of 3 views

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

This service was performed 175 times for 84 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 183 times for 103 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 99.32, 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: 99.32 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: 90.59

  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 comprises 40% of a provider's final MIPS score.
  
  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: 100

  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 comprises 25% of a provider's final MIPS score.
  
  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 comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: N/A

  The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.

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. Tyler Gonzalez is affiliated with the following medical facilities:

Frequently Asked Questions