ANDREW DAVID PANETTA
NPI 1972979953
Physician Assistant - Surgical in Bay Shore, NY

Medicare Participation & PECOS Enrollment Status

Andrew Panetta 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.

Andrew Panetta 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: 8325329287

  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: I20190808000854

  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.

Coronary artery bypass using artery graft, 1 graft

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

This service was performed 13 times for 13 patients

Harvest of vein using an endoscope

Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.

This service was performed 15 times for 15 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 84.47, 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: 84.47 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: 79.28

  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: 100

  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: 59.59

  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: 59.59

  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.

Hospital Compare Quality Information

Star ratings information gives patients a useful way to compare local hospitals by highlighting important quality factors like readmissions, mortality, safety of care, patient experience and timely and effective care. The ratings are presented as stars, ranging from 1 to 5. A higher number of stars indicates better performance in each quality aspect.

• Overall Quality Rating - 4 out of 5 stars - Good

  The overall rating is calculated by taking the weighted average of these group of scores. If a hospital is missing a measure category or group, the weights are redistributed amongst the qualifying measure categories or groups.

• Cleanliness - 2 out of 5 stars - Fair

  Cleanliness - star rating

• Quietness - 2 out of 5 stars - Fair

  Quietness - star rating

• Recommend Hospital - 3 out of 5 stars - Average

  Recommend hospital - star rating

• Care Transition - 2 out of 5 stars - Fair

  Care transition - star rating

• Discharge Information - 2 out of 5 stars - Fair

  Discharge information - star rating

• Communication About Medicines - 2 out of 5 stars - Fair

  Communication about medicines - star rating

• Staff Responsiveness - 2 out of 5 stars - Fair

  Staff responsiveness - star rating

• Doctor Communication - 3 out of 5 stars - Average

  Doctor communication - star rating

• Nurse Communication - 3 out of 5 stars - Average

  Nurse communication - star rating

• Hospital Type Acute Care Hospitals - Voluntary non-profit - Private

• Emergency Services: Yes

  Shows if the hospital provides emergency services like acute medical care or trauma care.

• Meaningful Use of Electronic Health Records: Y

  Shows if the hospital meets the criteria for promoting interoperability of Electronic Health Record Systems (EHRS).

Hospital Complications and Mortality Quality Ratings

• CMS Medicare PSI 90: Patient safety and adverse events composite is better than the national value

  Evaluation Period: July 2021 - June 2023

• Abdominopelvic accidental puncture or laceration rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Postoperative wound dehiscence rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Postoperative sepsis rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Perioperative pulmonary embolism or deep vein thrombosis rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Postoperative respiratory failure rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Postoperative acute kidney injury requiring dialysis rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Postoperative hemorrhage or hematoma rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• In-hospital fall-associated fracture rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Iatrogenic pneumothorax rate is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Death rate among surgical inpatients with serious treatable complications is no different than the national rate

  Evaluation Period: July 2021 - June 2023

• Pressure ulcer rate is better than the national rate

  Evaluation Period: July 2021 - June 2023

• Death rate for stroke patients is better than the national rate

  Evaluation Period: July 2020 - June 2023

• Death rate for pneumonia patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Death rate for heart failure patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Death rate for COPD patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Death rate for CABG surgery patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Death rate for heart attack patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Rate of complications for hip/knee replacement patients is no different than the national rate

  Evaluation Period: July 2020 - March 2023

Hospital Associated Infections Quality Ratings

• SSI - Colon Surgery is no different than national benchmark

  Evaluation Period: January 2023 - December 2023

• Catheter Associated Urinary Tract Infections (ICU + select Wards) is better than the national benchmark

  Evaluation Period: January 2023 - December 2023

• Central Line Associated Bloodstream Infection (ICU + select Wards) is better than the national benchmark

  Evaluation Period: January 2023 - December 2023

• Clostridium Difficile (C.Diff) is better than the national benchmark

  Evaluation Period: January 2023 - December 2023

• MRSA Bacteremia is no different than national benchmark

  Evaluation Period: January 2023 - December 2023

• SSI - Abdominal Hysterectomy is no different than national benchmark

  Evaluation Period: January 2023 - December 2023

Unplanned Hospital Visits Quality Ratings

• Pneumonia (PN) 30-Day Readmission Rate is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Rate of readmission after discharge from hospital (hospital-wide) is no different than the national rate

  Evaluation Period: July 2022 - June 2023

• Rate of readmission after hip/knee replacement is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Heart failure (HF) 30-Day Readmission Rate is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Rate of readmission for chronic obstructive pulmonary disease (COPD) patients is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Rate of readmission for CABG is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Acute Myocardial Infarction (AMI) 30-Day Readmission Rate is no different than the national rate

  Evaluation Period: July 2020 - June 2023

• Ratio of unplanned hospital visits after hospital outpatient surgery is no different than expected

  Evaluation Period: January 2022 - December 2022

• Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy is no different than the national rate

  Evaluation Period: January 2022 - December 2022

• Rate of inpatient admissions for patients receiving outpatient chemotherapy is no different than the national rate

  Evaluation Period: January 2022 - December 2022

• Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies) is no different than the national rate

  Evaluation Period: January 2020 - December 2022

• Hospital return days for pneumonia patients is more days than average per 100 discharges

  Evaluation Period: July 2020 - June 2023

• Hospital return days for heart failure patients is average days per 100 discharges

  Evaluation Period: July 2020 - June 2023

• Hospital return days for heart attack patients is average days per 100 discharges

  Evaluation Period: July 2020 - June 2023

Hospital Maternal Health Quality Ratings

• Elective Delivery percentage is 2%

  Percentage of mothers whose deliveries were scheduled 1 to 2 weeks early.
  Evaluation Period: January 2023 - December 2023

• Maternal Morbidity Structural Measure: Yes

  Assesses whether or not the hospital participates in a Perinatal Quality Improvement Collaborative Initiative.
  Evaluation Period: January 2023 - December 2023

Hospital Timely and Effective Care Quality Ratings

• Intensive Care Unit Venous Thromboembolism Prophylaxis is 98

  Evaluation Period: January 2023 - December 2023

• Venous Thromboembolism Prophylaxis is not available

  Evaluation Period: January 2023 - December 2023

• Discharged on Statin Medication is 94

  Evaluation Period: January 2023 - December 2023

• Antithrombotic Therapy by End of Hospital Day 2 is not available

  Evaluation Period: January 2023 - December 2023

• Anticoagulation Therapy for Atrial Fibrillation/Flutter is not available

  Evaluation Period: January 2023 - December 2023

• Discharged on Antithrombotic Therapy is 96

  Evaluation Period: January 2023 - December 2023

• Severe Sepsis 6-Hour Bundle is 82 %

  Septic Shock 6 Hour.
  Evaluation Period: January 2023 - December 2023

• Severe Sepsis 3-Hour Bundle is 79

  Evaluation Period: January 2023 - December 2023

• Septic Shock 6-Hour Bundle is 100 %

  Severe Sepsis 6 Hour.
  Evaluation Period: January 2023 - December 2023

• Septic Shock 3-Hour Bundle is 62 %

  Septic Shock 3 Hour.
  Evaluation Period: January 2023 - December 2023

• Appropriate care for severe sepsis and septic shock is 55 %

  Severe Sepsis and Septic Shock. Sepsis is a complication that happens when a patient has an extreme response to an infection. Higher percentages are better.
  Evaluation Period: January 2023 - December 2023

• Safe Use of Opioids - Concurrent Prescribing is 17

  Evaluation Period: January 2023 - December 2023

• ST-Segment Elevation Myocardial Infarction (STEMI) is not available

  Evaluation Period: January 2023 - December 2023

• Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery is not available %

  Percentage of patients who had cataract surgery and had improvement in visual function within 90 days following the surgery.
  Evaluation Period: January 2022 - December 2022

• Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients is 96 %

  Percentage of patients receiving appropriate recommendation for follow-up screening colonoscopy.
  Evaluation Period: January 2022 - December 2022

• Head CT results is not available %

  Percentage of patients who came to the emergency department with stroke symptoms who received brain scan results within 45 minutes of arrival.
  Evaluation Period: January 2023 - December 2023

• Left before being seen is 1 %

  Percentage of patients who left the emergency department before being seen.
  Evaluation Period: January 2022 - December 2022

• Average (median) time patients spent in the emergency department before leaving from the visit- Psychiatric/Mental Health Patients. A lower number of minutes is better is 291 minutes

  Average time patients spent in the emergency department before being sent home.
  Evaluation Period: January 2023 - December 2023

• Average (median) time patients spent in the emergency department before leaving from the visit A lower number of minutes is better is 232 minutes

  Average time patients spent in the emergency department before leaving from the visit.
  Evaluation Period: January 2023 - December 2023

• Healthcare workers given influenza vaccination is 61%

  Percentage of healthcare workers given influenza vaccination.
  Evaluation Period: October 2023 - March 2024

• Hospital Harm - Severe Hyperglycemia is not available

  Evaluation Period: January 2023 - December 2023

• Hospital Harm - Severe Hypoglycemia is not available

  Evaluation Period: January 2023 - December 2023

• Percentage of healthcare personnel who are up to date with COVID-19 vaccinations is 2%

  Percentage of healthcare personnel who completed COVID-19 primary vaccination series.
  Evaluation Period: October 2023 - December 2023

• Admit Decision Time to ED Departure Time for Admitted Patients - psychiatric/mental health disorders is not available

  Evaluation Period: January 2023 - December 2023

• Admit Decision Time to ED Departure Time for Admitted Patients - non psychiatric/mental health disorders is not available

  Evaluation Period: January 2023 - December 2023

• Emergency department volume is very high

  Evaluation Period: January 2022 - December 2022

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