JOHN PENNINGTON POOVEY D.M.D.
NPI 1841384492
Dentist - General Practice in Grand Junction, CO

Medicare Participation & PECOS Enrollment Status

John Poovey 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.

John Poovey 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) and a Home Health Agency (HHA).

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: 4587979042

  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: I20200618001043

  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: No

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.

Complete reconstruction of lower or upper jaw bone with jaw bone implant (endosteal)

A complete reconstruction of the lower or upper jaw bone involves the use of an endosteal implant. This procedure involves placing a small, sturdy post made of titanium into the jawbone. Over time, the bone grows around the post, providing a secure base for a replacement tooth.

This service was performed 29 times for 26 patients

Complex repair to increase depth of mouth

A complex repair to increase the depth of the mouth is a surgical procedure that enhances the mouth's capacity. It involves restructuring the oral cavity to allow for better functionality. The operation is done under anesthesia and recovery time varies.

This service was performed 74 times for 55 patients

Creation of window into nasal sinus

The creation of a window into the nasal sinus is a procedure to improve sinus drainage. A small opening is made in the sinus wall to allow mucus and air to flow freely. This can help alleviate symptoms of sinusitis, like congestion or pressure.

This service was performed 40 times for 35 patients

Impression and custom preparation of oral surgical splint

An oral surgical splint is a device designed to protect your mouth, align your jaw, or aid in healing after surgery. The process involves taking an impression of your teeth to create a splint that fits perfectly. This custom-made device ensures comfort and effectiveness.

This service was performed 15 times for 15 patients

Incision and repair of bony defect of cheek bone including bony segment reduction

This procedure involves making a cut to access the cheek bone that has a defect. The bone is then repaired, and if necessary, a portion of it is reduced or reshaped. The aim is to restore the normal structure and function of the cheek bone.

This service was performed 94 times for 64 patients

Insertion of bone grafts between portions of bone to enlarge lower jaw bone

The procedure involves placing bone grafts, which are small pieces of bone, in between sections of your lower jaw. This helps to increase the size and strength of the jawbone, improving its structure and function. It's a safe and effective way to enhance jaw health.

This service was performed 61 times for 36 patients

Irrigation of nasal sinus

Irrigation of nasal sinus is a procedure to clear your sinuses. A saline (salt water) solution is gently introduced into your nasal passages to flush out allergens, mucus, and other irritants. This can help alleviate symptoms like congestion or sinus headaches.

This service was performed 21 times for 21 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 15 times for 15 patients

Reconstruction of part of lower or upper jaw bone with implant

This procedure involves rebuilding a portion of your upper or lower jaw using an implant. The implant acts as a substitute for the missing bone, providing support and stability. This can improve your oral health, function, and appearance.

This service was performed 42 times for 29 patients

Removal of deep implant from bone

This procedure involves the careful extraction of an implant deeply embedded in a bone. A specialist makes a small incision, then utilizes precise instruments to reach and safely remove the implant. The area is then closed and monitored for healing.

This service was performed 19 times for 13 patients

Removal of face bone

Removal of a facial bone is a surgical procedure aimed at treating conditions like tumors or fractures. It involves making incisions to access the affected bone, then carefully removing it. This procedure requires general anesthesia and may result in temporary facial swelling or numbness.

This service was performed 66 times for 43 patients

Removal of lower jaw bone

The removal of the lower jaw bone, or mandibulectomy, is a surgical procedure performed to treat conditions like oral cancer or severe trauma. It involves removing part or all of the lower jaw to prevent disease spread or repair damage. Post-surgery, reconstructive measures may be taken for functionality and appearance.

This service was performed 72 times for 46 patients

Repair of abnormal drainage tract between nasal sinuses

This procedure addresses an irregular drainage pathway from your nasal sinuses. The doctor uses a small, flexible tube with a camera to view the area and correct the issue. This helps to prevent infections and improve breathing.

This service was performed 51 times for 37 patients

Repair of lower jaw bone with bone graft

This procedure involves the use of bone grafts to repair defects or damages in your lower jaw bone. A bone graft is a piece of bone taken from another part of your body or a special bone material. It helps stimulate new bone growth and provide structural stability.

This service was performed 103 times for 50 patients

Repair of nasal or cheek bone with bone graft

This procedure involves fixing damaged nasal or cheek bones using a bone graft. A bone graft is a piece of healthy bone taken from another area of your body, or a special bone-like material. It's used to help your damaged bone heal, restore its original shape, or improve its function.

This service was performed 98 times for 51 patients

Repair to increase depth on side of mouth

This procedure aims to enhance the depth on the side of your mouth, often for cosmetic or functional reasons. It involves a minor surgical process where your doctor adjusts the tissues around your mouth to create a deeper appearance. This is done under local anesthesia.

This service was performed 20 times for 18 patients

X-ray of lower jaws, upper jaws and teeth

An X-ray of lower jaws, upper jaws, and teeth is a diagnostic procedure that uses radiation to create images of these areas. This helps in identifying issues like tooth decay, gum problems, or jawbone irregularities. It's a quick, painless process and crucial for maintaining oral health.

This service was performed 17 times for 17 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.35 for a new patient copayment and $18.05 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 81501 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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