SEVARA JEAN BAILEY NP
NPI 1770028409
Nurse Practitioner - Family in Irvine, CA

Medicare Participation & PECOS Enrollment Status

Sevara Bailey 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.

Sevara Bailey 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: 5799114906

  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: I20200408003296, I20220921002001, I20240809003575, I20250331003091

  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 (DA023N)

  Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)

  1 DME suppliers used 19 Medicare Claims 960 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Collagen dressing, sterile, size more than 48 sq. in., each (HCPCS:A6023)

  1 DME suppliers used 17 Medicare Claims 510 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)

  1 DME suppliers used 29 Medicare Claims 1201 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing (HCPCS:A6197)

  1 DME suppliers used 34 Medicare Claims 1380 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)

  1 DME suppliers used 42 Medicare Claims 876 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing (HCPCS:A6214)

  1 DME suppliers used 12 Medicare Claims 192 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6219)

  1 DME suppliers used 27 Medicare Claims 702 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing (HCPCS:A6220)

  1 DME suppliers used 41 Medicare Claims 1116 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6222)

  1 DME suppliers used 15 Medicare Claims 510 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6251)

  1 DME suppliers used 18 Medicare Claims 540 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6252)

  1 DME suppliers used 14 Medicare Claims 252 Services Paid

• DME-Medical/Surgical Supplies (DA023N)

  Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing (HCPCS:A6253)

  1 DME suppliers used 37 Medicare Claims 864 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.

Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less

This procedure involves applying a skin substitute graft to a wound on the trunk, arms, or legs. The graft, a lab-grown skin, is used to cover a wound area of 25.0 sq cm or less, within a total wound area of 100.0 sq cm or less. It aids in healing and regeneration.

This service was performed 147 times for 19 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

This service was performed 166 times for 162 patients

Established patient home visit, typically 25 minutes

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

This service was performed 177 times for 45 patients

New patient home visit, typically 30 minutes

A new patient home visit is a 30-minute appointment where a healthcare provider comes to your home to assess your health needs. This can include discussing your medical history, current conditions, and treatment plans. It's a convenient way to receive care in your own environment.

This service was performed 45 times for 45 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 166 times for 162 patients

Removal of inflamed or infected skin, up to 10% of body surface

This procedure involves the surgical removal of inflamed or infected skin covering up to 10% of your body surface. It's done to prevent the spread of infection and promote healing. Local or general anesthesia is used to ensure comfort during the process.

This service was performed 19 times for 13 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 193 times for 44 patients

Zenith amniotic membrane, per square centimeter

The Zenith amniotic membrane is a type of treatment derived from the amniotic membrane, a part of the placenta. It's used to promote healing in various medical conditions, often involving the eyes or skin. It can help reduce inflammation, prevent scarring, and stimulate tissue regeneration.

This service was performed 1,292 times for 11 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $24.09 for a new patient copayment and $27.49 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 92614 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.

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