DR. NAEEM MARKARM GOUSSOUS MD
NPI 1801162623
Transplant Surgery in Sacramento, CA

Medicare Participation & PECOS Enrollment Status

Naeem Goussous 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.

Naeem Goussous 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: 1850549239

  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: I20201207000883

  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 kidney

A kidney biopsy is a medical procedure where a tiny piece of your kidney is removed for testing. This helps doctors identify any abnormalities or diseases. It is usually performed using a special needle under imaging guidance to ensure precision.

This service was performed 22 times for 22 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 11 times for 11 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 26 times for 26 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 22 times for 21 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 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 18 times for 18 patients

Insertion of stent in ureter

A ureteral stent is a soft, hollow tube placed temporarily into your ureter to help urine drain from your kidney to your bladder. It can assist with kidney stone passage or relieve a blockage. The procedure is done under anesthesia, and discomfort post-procedure is minimal.

This service was performed 34 times for 34 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

Preparation of donor kidney and veins for transplantation

In kidney transplantation, a healthy kidney is taken from a donor. The kidney is carefully prepared, cleaned, and preserved. Veins are also prepared to ensure smooth blood flow to the new kidney. This process is done under strict medical protocols.

This service was performed 32 times for 17 patients

Preparation of donor kidney for transplantation

Preparation of a kidney for transplantation involves careful evaluation of the donor organ. It includes checking for diseases, ensuring compatibility, and preserving the organ in a cold solution until transplantation. This process ensures the best outcome for the recipient.

This service was performed 34 times for 34 patients

Relocation of arm vein with connection to arm artery for hemodialysis

This procedure involves moving a vein in your arm and connecting it to an artery. This creates a larger, stronger vein that can be used for hemodialysis, a treatment for kidney disease. It helps clean your blood when your kidneys can't.

This service was performed 11 times for 11 patients

Removal of abdominal cavity tube

The removal of an abdominal cavity tube is a medical procedure that involves taking out a tube previously placed in your abdomen. This tube may have been used to drain fluid, air, or pus from your abdominal area. The process is safe, typically quick, and done by a healthcare professional.

This service was performed 20 times for 20 patients

Removal of kidney from living donor using an endoscope

This procedure involves the use of an endoscope, a thin tube with a camera, to remove a kidney from a living donor. The endoscope is inserted through a small incision, allowing the surgeon to see and remove the kidney with minimal impact on the body.

This service was performed 11 times for 11 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

This service was performed 19 times for 19 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

This service was performed 20 times for 20 patients

Transplantation of donor kidney

Transplantation of a donor kidney involves replacing a non-functioning kidney with a healthy one from a donor. This procedure can significantly improve the quality of life for those with serious kidney disease. The new kidney can perform the essential task of filtering blood and removing waste.

This service was performed 36 times for 36 patients

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