MICHAEL E SMITH D.P.M.
NPI 1902975105
Podiatrist - Foot & Ankle Surgery in Winter Park, FL

Medicare Participation & PECOS Enrollment Status

Michael Smith 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.

Michael Smith 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: 2163477183

  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: I20050314000059

  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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  1 DME suppliers used 15 Medicare Claims 15 Services Paid

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.

Amputation of foot across instep

Amputation of the foot across the instep is a surgical procedure where the foot is removed at the level of the instep due to severe injury, infection, or disease. This helps prevent the spread of disease and improves overall health.

This service was performed 17 times for 15 patients

Amputation of toe and midfoot bone

Amputation of toe and midfoot bone is a surgical procedure performed to remove one or more toes and part of the foot's bone structure. This is typically done to treat severe injury, infection, or circulation problems in the foot. The goal is to preserve function and relieve pain.

This service was performed 13 times for 12 patients

Amputation of toe at toe joint

Amputation of a toe at the toe joint is a surgical procedure that involves removing part or all of a toe. It's typically done to treat severe injury or infection that hasn't responded to other treatments. After the procedure, physical therapy may be needed for optimal recovery.

This service was performed 25 times for 22 patients

Biopsy of bone using needle or trocar

A biopsy of the bone using a needle or trocar is a procedure where a small sample of bone tissue is collected for testing. This helps diagnose conditions such as infection, inflammation, or cancer. The process involves inserting a thin needle or trocar into the bone to extract the sample.

This service was performed 33 times for 29 patients

Biopsy of surface bone

A biopsy of surface bone is a procedure where a small piece of bone tissue is removed for examination. This helps to diagnose conditions such as cancer or infections. It involves a needle or small incision, and may require local or general anesthesia.

This service was performed 25 times for 20 patients

Drainage of fluid filled sac below connective tissue in foot joint

This procedure involves draining a fluid-filled sac, known as a bursa, located beneath the connective tissue in your foot joint. It's done to relieve discomfort and reduce swelling. A needle is used to remove the excess fluid, providing relief.

This service was performed 30 times for 25 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 144 times for 42 patients

Extensive or complicated repair of surface wound reopening

This procedure involves the repair of a surface wound that has reopened. It may be extensive or complex due to the wound's size, depth, or location. The process includes cleaning the wound, removing any damaged tissue, and stitching it closed to promote healing.

This service was performed 22 times for 20 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 218 times for 198 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 30 times for 27 patients

Partial removal of foot or heel bone

This procedure involves the surgical removal of a portion of the foot or heel bone. It's typically done to treat conditions like arthritis, bone spurs, or injuries. The goal is to alleviate pain and improve mobility. After surgery, physical therapy may be necessary for full recovery.

This service was performed 17 times for 16 patients

Removal of skin and tissue, 20.0 sq cm or less

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

This service was performed 17 times for 16 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 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 704 times for 183 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 28 times for 18 patients

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. Michael Smith is affiliated with the following medical facilities:

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