DR. JAMES E TEELA DPM
NPI 1932111879
Podiatrist in Cutler, CA

Medicare Participation & PECOS Enrollment Status

James Teela 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.

James Teela 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: 7012988967

  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: I20150613000131

  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.

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe (HCPCS:A5500)

  1 DME suppliers used 33 Medicare Claims 66 Services Paid

• DME-Orthotic Devices (DF000N)

  For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each (HCPCS:A5513)

  1 DME suppliers used 28 Medicare Claims 161 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.

Biopsy of fingernail or toenail

A biopsy of a fingernail or toenail is a medical procedure where a small piece of your nail or the tissue under it is removed for testing. This can help diagnose conditions like infections or skin diseases. The area is numbed for your comfort during the process.

This service was performed 728 times for 364 patients

Detection test by nucleic acid for organism, amplified probe technique

A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.

This service was performed 377 times for 23 patients

Detection test by nucleic acid for organism, quantification

A detection test by nucleic acid quantification is a lab procedure used to identify specific organisms in your body. It measures the amount of an organism's genetic material, helping to diagnose and monitor certain diseases.

This service was performed 921 times for 307 patients

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique

A detection test for Staphylococcus aureus uses a method called the amplified probe technique. This method identifies the bacteria's unique genetic material, or nucleic acid, helping to confirm its presence. It's a highly accurate way to detect this type of bacteria.

This service was performed 29 times for 23 patients

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique

This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.

This service was performed 29 times for 23 patients

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique

A detection test by nucleic acid for Group B Strep uses an amplified probe technique. This test identifies the presence of Group B Strep bacteria in the body. It involves collecting a sample, usually a swab, which is then examined in a lab for the bacteria's genetic material.

This service was performed 29 times for 23 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 717 times for 356 patients

Injection into tendon or ligament

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

This service was performed 30 times for 25 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 28 times for 24 patients

Limited ultrasound scan of joint or other extremity structure lacking blood vessels

A limited ultrasound scan of a joint or other extremity structure lacking blood vessels is a non-invasive procedure that uses sound waves to create images of the inside of your body. This helps in diagnosing and monitoring conditions related to your joints or other similar structures.

This service was performed 46 times for 25 patients

Molecular pathology procedure; physician interpretation and report

A molecular pathology procedure involves analyzing your body's cells at a molecular level to identify any abnormalities. This can help detect diseases early. A physician will interpret the results and provide a detailed report, explaining the findings clearly.

This service was performed 987 times for 316 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 365 times for 365 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 638 times for 319 patients

Permanent removal fingernail or toenail

Permanent removal of a fingernail or toenail, also known as avulsion, is a procedure performed to treat nail infections or severe ingrown nails. The nail is carefully removed under local anesthesia. After removal, a chemical is applied to prevent nail regrowth, ensuring the issue does not recur.

This service was performed 14 times for 11 patients

Placement of strapping to ankle or foot

Strapping to the ankle or foot is a procedure involving the application of tape or a similar material to provide support and stability. It can help manage injuries, reduce pain, and prevent further harm. The process is non-invasive and typically performed by a trained professional.

This service was performed 24 times for 22 patients

Preparation of specimen, manual

The preparation of a specimen manually is a procedure where a sample from your body is collected by a healthcare professional. This could be blood, urine, or tissue. The sample is then prepared in a lab for further analysis to help diagnose or monitor your health condition.

This service was performed 318 times for 318 patients

Removal of fingernails or toenails, 6 or more nails

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

This service was performed 2,118 times for 689 patients

Removal of noncancer thickened skin growth, 1 growth

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

This service was performed 48 times for 38 patients

Removal of noncancer thickened skin growth, 2-4 growths

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

This service was performed 744 times for 284 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 201 times for 47 patients

Removal of tissue from wound, 20.0 sq cm or less

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

This service was performed 63 times for 34 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 638 times for 319 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 1,276 times for 319 patients

Ultrasonic guidance for needle placement

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

This service was performed 25 times for 14 patients

Ultrasound of leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

This service was performed 138 times for 92 patients

Ultrasound of one leg arteries or artery grafts

An ultrasound of leg arteries or artery grafts is a non-invasive test using sound waves to create images of your blood vessels. This helps doctors assess blood flow, identify blockages, and monitor the health of grafts.

This service was performed 32 times for 21 patients

Ultrasound study of arm or leg veins with compression and maneuvers

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

This service was performed 85 times for 69 patients

X-ray of foot, minimum of 3 views

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

This service was performed 193 times for 84 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.58 for a new patient copayment and $18.29 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 93615 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.

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 83.57, 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: 83.57 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: 33.93

  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: 40

  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: 100

  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: 100

  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.

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