ELIE R SOUSSAN M.D.
NPI 1891958674
Obstetrics & Gynecology in Little Silver, NJ
- Individual
- Male
- Years of Experience 21
- Obstetrics & Gynecology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About ELIE SOUSSAN
This page provides the complete NPI Profile along with additional information for Elie Soussan, a women's health care provider established in Little Silver, New Jersey with a medical specialization in Obstetrics & Gynecology and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1891958674 assigned on July 2008. The practitioner's primary taxonomy code is 207V00000X with license number 25MA08834200 (NJ). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1891958674 Verify this NPI
- Provider Name
- ELIE R SOUSSAN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 34 SYCAMORE AVE SUITE 2A LITTLE SILVER, NJ 07739
- Location Phone
- (732) 747-9310
- Location Fax
- (732) 747-9320
- Mailing Address
- 34 SYCAMORE AVE SUITE 2A LITTLE SILVER, NJ 07739
- Mailing Phone
- (732) 747-9310
- Mailing Fax
- (732) 747-9320
- Medical School Name
- OTHER
- Graduation Year
- 2006
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-02-2008
- Last Update Date
- 03-03-2015
- Code Navigator
Women's health care providers like Elie Soussan treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA08834200
- License State
- NJ
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Elie Soussan 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.
Elie Soussan 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: 6103051511
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: I20131021000118
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.08 for a new patient copayment and $19.11 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 07739 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.34
- Minimum New Patient Price $61.59
- Maximum New Patient Price $185.05
- Average New Patient Copayment $35.08
- Minimum New Patient Copayment $15.39
- Maximum New Patient Copayment $46.26
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.45
- Minimum Established Patient Price $20.08
- Maximum Established Patient Price $150.98
- Average Established Patient Copayment $19.11
- Minimum Established Patient Copayment $5.02
- Maximum Established Patient Copayment $37.74
* 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.
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 82% | 108 |
| Cervical Cancer Screening | 95% | 711 |
| Documentation of Current Medications in the Medical Record | 92% | 1031 |
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 37% | 448 |
| Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented | 49% | 911 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 1% | 733 |
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 1% | 733 |
Reviews for ELIE R SOUSSAN M.D.
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Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
LITTLE SILVER, NJ 07739
LITTLE SILVER, NJ 07739
LITTLE SILVER, NJ 07739
LITTLE SILVER, NJ 07739
LITTLE SILVER, NJ 07739
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891958674, enumerated as an "individual" on July 02, 2008.
The provider is located at 34 SYCAMORE AVE SUITE 2A LITTLE SILVER, NJ 07739 and the phone number is (732) 747-9310.
Obstetrics & Gynecology with taxonomy code 207V00000X.
The provider might be accepting Accepts: Ambetter Health and Ambetter Health of Delaware. Please consult your insurance carrier or call the provider to verify.
