DR. YAHYA JOHN TALIEH M.D.
NPI 1780624619
Specialist in Modesto, CA

Medicare Participation & PECOS Enrollment Status

Yahya Talieh 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.

Yahya Talieh 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: 3476455627

  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: I20040127000292

  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.

Coronary artery bypass graft (CABG)

Coronary artery bypass graft (CABG) is a surgery to improve blood flow to your heart. It involves taking a blood vessel from another part of your body and using it to reroute blood around a blocked or narrowed artery in your heart. This can help reduce chest pain and minimize the risk of heart attacks.

This service was performed for 72 patients

Coronary artery bypass using artery graft, 1 graft

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

This service was performed 41 times for 41 patients

Coronary artery bypass using vein or artery graft, 2 grafts

A coronary artery bypass with 2 grafts is a surgery to improve blood flow to your heart. A surgeon takes a healthy vein or artery from your body and attaches it to the blocked coronary artery. This creates a new path for blood to flow, bypassing the blockage.

This service was performed 14 times for 14 patients

Coronary artery bypass using vein or artery graft, 3 grafts

A coronary artery bypass with 3 grafts is a surgery to improve blood flow to the heart. Veins or arteries from other parts of your body are used to bypass blocked coronary arteries. This helps to restore normal blood flow to the heart, reducing the risk of heart disease.

This service was performed 14 times for 14 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 18 times for 16 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 110 times for 96 patients

Exclusion of appendage of left upper chamber of heart performed during other procedure on chest

This is a procedure done on the heart's left upper chamber (atrium). The small pouch-like appendage is sealed off during another chest procedure. This is done to reduce the risk of blood clots forming and causing strokes.

This service was performed 12 times for 12 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 63 times for 43 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 132 times for 123 patients

Harvest of vein using an endoscope

Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.

This service was performed 24 times for 24 patients

Leg revascularization (restoring blood flow)

Leg revascularization is a procedure aimed at restoring proper blood flow to your legs. It's often needed when blood vessels in your legs are blocked or narrowed. The process may involve surgery or less invasive methods to remove or bypass blockages, helping to alleviate pain and prevent serious complications.

This service was performed for 13 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 55 times for 55 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 110 times for 110 patients

Pacemaker insertion or repair

Pacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.

This service was performed for 1-10 patients

Relocation of major upper arm vein with connection to arm artery for hemodialysis

This procedure adjusts your upper arm vein's position and connects it to an arm artery to improve blood flow. It's used for hemodialysis, a treatment that cleans your blood when your kidneys can't. It makes the dialysis process more efficient and comfortable.

This service was performed 20 times for 19 patients

Relocation of upper arm surface vein with connection to arm artery for hemodialysis

This procedure involves moving a vein from your upper arm to a location near the surface of your skin, then connecting it to an artery. This creates a larger, stronger vein that can handle the frequent needle insertions needed for hemodialysis, a treatment for kidney disease.

This service was performed 19 times for 18 patients

Removal of blood clot and portion of chest, neck, or brain artery

This procedure involves the removal of a blood clot and a section of an artery in the chest, neck, or brain. It is often necessary to restore normal blood flow, prevent stroke, or alleviate symptoms related to the clot. The procedure is carried out by a skilled medical team.

This service was performed 19 times for 19 patients

Removal of plaque from heart artery at time of coronary artery bypass

During a coronary artery bypass, plaque is removed from heart arteries to improve blood flow. This procedure, also known as endarterectomy, helps prevent heart attacks by clearing blockages. It's a common addition to bypass surgery to ensure optimal heart health.

This service was performed 11 times for 11 patients

Replacement of aortic valve through the skin and femoral artery

This procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.

This service was performed 59 times for 58 patients

Revision of hemodialysis graft

A revision of a hemodialysis graft is a procedure to fix issues with the graft used for dialysis. This can involve clearing blockages or improving blood flow. It helps ensure the graft continues to work effectively for your dialysis treatments.

This service was performed 11 times for 11 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 22.85, 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: 22.85 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: 0

  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: 0

  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: 76.18

  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: 76.18

  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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