DR. HUMMAYUN ISMAIL M.D.
NPI 1962422469
Internal Medicine - Pulmonary Disease in Newark, DE
About Dr. Hummayun Ismail M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. HUMMAYUN ISMAIL M.D. (NPI 1962422469) is an individual pulmonary disease provider in Newark, Delaware, licensed in Delaware (C10005113) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1990).
NPPES Registry Identity
Specialties & Licenses 2
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Hummayun Ismail M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
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-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
14 DME suppliers used 235 Medicare Claims 235 Services Paid
DME-Other DME (DE000N)
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)
1 DME suppliers used 15 Medicare Claims 30 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
13 DME suppliers used 592 Medicare Claims 592 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
12 DME suppliers used 581 Medicare Claims 1627 Services Paid
DME-Other DME (DE001N)
Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)
10 DME suppliers used 243 Medicare Claims 1315 Services Paid
DME-Other DME (DE001N)
Pillow for use on nasal cannula type interface, replacement only, pair (HCPCS:A7033)
8 DME suppliers used 161 Medicare Claims 885 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
15 DME suppliers used 425 Medicare Claims 426 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
19 DME suppliers used 610 Medicare Claims 610 Services Paid
DME-Other DME (DE001N)
Chinstrap used with positive airway pressure device (HCPCS:A7036)
4 DME suppliers used 38 Medicare Claims 38 Services Paid
DME-Other DME (DE001N)
Tubing used with positive airway pressure device (HCPCS:A7037)
14 DME suppliers used 745 Medicare Claims 747 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
18 DME suppliers used 1071 Medicare Claims 5577 Services Paid
DME-Other DME (DE001N)
Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)
8 DME suppliers used 115 Medicare Claims 115 Services Paid
DME-Other DME (DE001N)
Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)
19 DME suppliers used 423 Medicare Claims 423 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
3 DME suppliers used 229 Medicare Claims 238 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)
2 DME suppliers used 34 Medicare Claims 34 Services Paid
DME-Other DME (DE005N)
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) (HCPCS:E0466)
1 DME suppliers used 57 Medicare Claims 57 Services Paid
DME-Other DME (DE001N)
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (HCPCS:E0470)
5 DME suppliers used 124 Medicare Claims 125 Services Paid
DME-Other DME (DE001N)
Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)
5 DME suppliers used 41 Medicare Claims 41 Services Paid
DME-Other DME (DE001N)
Humidifier, heated, used with positive airway pressure device (HCPCS:E0562)
2 DME suppliers used 662 Medicare Claims 672 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
4 DME suppliers used 108 Medicare Claims 108 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
7 DME suppliers used 851 Medicare Claims 867 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
6 DME suppliers used 512 Medicare Claims 524 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
7 DME suppliers used 162 Medicare Claims 169 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary (HCPCS:G0333)
5 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)
2 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
20 DME suppliers used 87 Medicare Claims 87 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)
4 DME suppliers used 20 Medicare Claims 1200 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
15 DME suppliers used 65 Medicare Claims 15662 Services Paid
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
5 DME suppliers used 19 Medicare Claims 2460 Services Paid
DME-Drugs Administered Through DME (DG000N)
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)
7 DME suppliers used 19 Medicare Claims 1350 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.
Critical care, first 30-74 minutes
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days
Sleep study in sleep lab (6 years or older)
Sleep study in sleep lab with continuous airway pressure (6 years or older)
Sleep study including heart rate, breathing, airflow, and effort
Sleep study including heart rate, breathing, airflow, and effort
Sleep study including heart rate, breathing, and sleep time
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
Test for exercise-induced lung stress
Test to determine lung volumes using sensors
Test to examine how well the lungs exchange gases
Test to measure expiratory airflow and volume changes before and after medication administration
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 118 times for 22 patientsThis 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 360 times for 207 patientsThis 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 1,550 times for 599 patientsThis 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 16 times for 16 patientsInitial 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 123 times for 117 patientsInitial 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 52 times for 52 patientsThis service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
This service was performed 51 times for 22 patientsThis service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
This service was performed 254 times for 38 patientsThis 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 149 times for 149 patientsThis 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 13 times for 13 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 142 times for 142 patientsThis service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
This service was performed 331 times for 38 patientsA sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
This service was performed 90 times for 86 patientsA sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
This service was performed 57 times for 54 patientsA sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.
This service was performed 21 times for 21 patientsA sleep study monitors your heart rate, breathing patterns, airflow, and physical effort while you sleep. It helps identify sleep disorders by tracking your sleep stages and cycles. This data aids doctors in diagnosing and treating sleep-related issues.
This service was performed 70 times for 68 patientsA sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
This service was performed 117 times for 116 patientsFollow-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 1,700 times for 121 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 2,409 times for 102 patientsAn exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.
This service was performed 18 times for 18 patientsThis test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
This service was performed 157 times for 157 patientsThis is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
This service was performed 157 times for 157 patientsThis procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
This service was performed 157 times for 157 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.78 for a new patient copayment and $25.17 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 19713 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $131.15
- Minimum New Patient Price $57.12
- Maximum New Patient Price $173.08
- Average New Patient Copayment $32.78
- Minimum New Patient Copayment $14.28
- Maximum New Patient Copayment $43.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.68
- Minimum Established Patient Price $18.36
- Maximum Established Patient Price $141.05
- Average Established Patient Copayment $25.17
- Minimum Established Patient Copayment $4.59
- Maximum Established Patient Copayment $35.26
* 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.
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.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care Plan | 49% | 814 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation | 71% | 429 |
| Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented | ||
| Documentation of Current Medications in the Medical Record | 100% | 5384 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 52% | 1291 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 100% | 48 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Medication Reconciliation | 99% | 290 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 10% | 1129 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 39% | 813 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 15% | 2035 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 49% | 146 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 25% | 1374 |
| Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 100% | 1129 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 4% | 1129 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962422469, enumerated as an "individual" on July 20, 2006.
The provider is located at 550 STANTON CHRISTIANA RD STE 103 NEWARK, DE 19713 and the phone number is (302) 633-9033.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from NH. Please consult your insurance carrier or call the provider to verify.
