AINEL BOONPRAKONG SEWELL M.D.
NPI 1780851006
Radiology - Diagnostic Radiology in Durham, NC

Medicare Participation & PECOS Enrollment Status

Ainel Sewell 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.

Ainel Sewell 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: 1951547801

  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: I20160429000382

  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.

Biopsy of breast and placement of locating device using ultrasound, first growth

A breast biopsy with locating device placement involves taking a small sample from an unusual growth, using ultrasound for precise targeting. This sample is studied for any abnormal cells. A locating device is also placed to mark the area for future reference.

This service was performed 34 times for 32 patients

Complete ultrasound scan of 1 breast

A complete ultrasound scan of one breast is a non-invasive imaging test that uses sound waves to create detailed images of the inside of your breast. It helps in detecting any abnormalities or changes, ensuring your breast health.

This service was performed 162 times for 159 patients

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)

Diagnostic digital breast tomosynthesis is a 3D imaging test that allows doctors to examine your breast tissue layer by layer. It's performed on one or both sides. It helps in detecting abnormalities more accurately. It's often done in addition to other tests.

This service was performed 242 times for 241 patients

Diagnostic mammography of 1 breast

Diagnostic mammography of 1 breast is a detailed imaging test that allows doctors to closely examine a specific area in the breast. It's often used when a routine screening reveals an abnormality. This test can help identify any unusual changes or issues.

This service was performed 133 times for 114 patients

Diagnostic mammography of both breasts

Diagnostic mammography involves using special imaging technology to capture detailed images of both breasts. This procedure helps in identifying any unusual changes or abnormalities. It's a crucial step in ensuring breast health and early detection of potential issues.

This service was performed 181 times for 180 patients

Limited ultrasound scan of 1 breast

A limited ultrasound scan of one breast is a non-invasive imaging test. It uses sound waves to create pictures of the inside of your breast. It helps identify any unusual growths or changes. It's safe, quick, and typically painless.

This service was performed 100 times for 95 patients

Mri scan of both breasts

An MRI scan of both breasts is a non-invasive procedure using magnetic fields and radio waves to create detailed images of your chest area. This aids in detecting any abnormalities, ensuring your health and well-being.

This service was performed 14 times for 13 patients

Placement of locating device in breast using ultrasound guidance, first growth

This procedure involves inserting a small locating device into the breast tissue using ultrasound. The device helps accurately mark the position of the first growth. This aids in precise treatment planning. It's a non-invasive process with minimal discomfort.

This service was performed 14 times for 14 patients

Screening 3d breast mammography

Screening 3D breast mammography is a procedure that uses low-dose X-rays to create detailed images of the breast. This allows for early detection of any unusual changes or growths. It's a non-invasive, outpatient procedure that typically takes about 30 minutes.

This service was performed 1,462 times for 1,462 patients

Screening mammography

Screening mammography is a preventative measure that uses low-dose X-rays to take images of the chest area. It's a key tool in early detection of abnormalities, helping to identify issues before they become symptomatic. It is recommended annually for certain age groups.

This service was performed 1,458 times for 1,458 patients

X-ray of surgical specimen

An X-ray of a surgical specimen involves taking detailed images of the tissue or organ removed during surgery. This helps in examining the specimen more closely to understand the disease better. It's a safe, non-invasive procedure, providing valuable insights to your healthcare team.

This service was performed 19 times for 18 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 for a new patient copayment and $16.93 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 27704 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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. Ainel Sewell is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1780851006 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

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The following 20 providers are registered at the same or nearby location.

Frequently Asked Questions