DR. NIKESH SETH MD
NPI 1922327030
Anesthesiology - Pain Medicine in Scottsdale, AZ

Medicare Participation & PECOS Enrollment Status

Nikesh Seth 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.

Nikesh Seth 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: 1254501760

  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: I20110818000746, I20221230000176, I20260106001364

  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.

Administration of psychological or neuropsychological test, first 30 minutes

This procedure involves a health professional conducting a psychological or neuropsychological test. The first 30 minutes typically involve understanding your mental health or brain function through various assessments. This helps in diagnosing and treating mental health disorders effectively.

This service was performed 98 times for 98 patients

Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes

This service involves a structured evaluation of your alcohol or substance use habits. It identifies potential issues and provides brief counseling to help modify harmful behaviors. It's a short, 15-30 minute process, focused on promoting healthier choices.

This service was performed 100 times for 100 patients

Annual depression screening, 15 minutes

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

This service was performed 51 times for 51 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 16 times for 15 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 43 times for 32 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 89 times for 49 patients

Assessment of emotional or behavioral problems

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

This service was performed 66 times for 56 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 1,430 times for 467 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 101 times for 42 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves using imaging technology to locate and treat nerves in your lower spine or sacral area that may be causing pain. Each additional facet joint refers to treating more than one spinal nerve. It's a non-invasive way to manage chronic back pain.

This service was performed 65 times for 28 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 71 times for 42 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 45 times for 28 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves the use of imaging technology to accurately target and destroy nerves in the upper or middle spinal facet joints, which may be causing pain. Each additional facet joint treated follows the same process.

This service was performed 37 times for 15 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint

This procedure involves the use of imaging technology to accurately target and destroy nerves in the upper or middle spinal facet joints, which may be causing pain. Each additional facet joint treated follows the same process.

This service was performed 31 times for 13 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 25 times for 15 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 20 times for 13 patients

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms

A definitive drug test identifies specific drugs in your system. It uses advanced methods like gc/ms and lc/ms, which can distinguish between different types of drugs but not necessarily their 3D forms. This test offers detailed results to support your healthcare decisions.

This service was performed 1,041 times for 428 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 19 times for 18 patients

Established patient office or other outpatient visit, 20-29 minutes

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 128 times for 93 patients

Established patient office or other outpatient visit, 30-39 minutes

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 1,150 times for 434 patients

Fluoroscopic guidance for needle placement

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

This service was performed 12 times for 11 patients

Fluoroscopic guidance for needle placement

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

This service was performed 28 times for 22 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 144 times for 84 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 145 times for 84 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

This service was performed 54 times for 32 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level

This procedure involves injecting an anesthetic or steroid drug into the sacral spine nerve root. It's done under imaging guidance to ensure accuracy. The process can be repeated for each additional level of the spine to help manage pain or inflammation.

This service was performed 48 times for 38 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 105 times for 63 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 102 times for 67 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

This service was performed 35 times for 27 patients

Injection of drug or substance into vein

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

This service was performed 145 times for 84 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 52 times for 29 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 38 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 37 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 38 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 37 times for 25 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 42 times for 24 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 49 times for 31 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 71 times for 38 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 63 times for 36 patients

Injection of trigger points, 3 or more muscles

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

This service was performed 36 times for 24 patients

Injection of upper or middle spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the upper or middle spine facet joint, a small joint in your back. This is done under imaging guidance for precision. It's a second-level procedure, meaning it's done on two separate joints. It can help reduce pain and inflammation.

This service was performed 28 times for 17 patients

Injection of upper or middle spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the upper or middle spine facet joint, a small joint in your back. This is done under imaging guidance for precision. It's a second-level procedure, meaning it's done on two separate joints. It can help reduce pain and inflammation.

This service was performed 27 times for 16 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 28 times for 17 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 27 times for 16 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 4,325 times for 213 patients

Injection, fentanyl citrate, 0.1 mg

Fentanyl citrate is a potent pain medication administered via injection. The 0.1 mg dosage is used to manage severe pain conditions. It works by blocking pain signals to the brain. It's crucial to follow the dosage instructions to prevent potential side effects.

This service was performed 147 times for 85 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

This service was performed 112 times for 29 patients

Injection, midazolam hydrochloride, per 1 mg

Midazolam hydrochloride is a medication injected to help you relax or sleep before surgery or certain medical procedures. It works by calming the brain and nerves. It's given in small doses, measured in milligrams (mg).

This service was performed 145 times for 85 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 28 times for 28 patients

New patient office or other outpatient visit, 45-59 minutes

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 117 times for 117 patients

Professional service for preparation and provision of 1 or more antigens

This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.

This service was performed 4,670 times for 17 patients

Psychiatric diagnostic evaluation

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

This service was performed 27 times for 27 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 1-10 patients

Test for allergy using allergenic extract

An allergy test with allergenic extract is a diagnostic method to identify substances causing allergic reactions. Small amounts of common allergens are introduced to your body, usually through skin pricks or blood tests. Your body's response helps determine your allergies.

This service was performed 1,512 times for 21 patients

Testing for presence of drug, by chemistry analyzers

Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.

This service was performed 1,050 times for 431 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 24 times for 22 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 144 times for 84 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 75 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: N/A

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: N/A

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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.

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Frequently Asked Questions