DAVID J PINNELAS M.D.
NPI 1982683025
Internal Medicine - Cardiovascular Disease in Neptune, NJ
About David J Pinnelas M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID J PINNELAS M.D. (NPI 1982683025) is an individual cardiovascular disease provider in Neptune, New Jersey, licensed in New Jersey (25MA05743000) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (1984).
NPPES Registry Identity
Specialties & Licenses 3
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Other Identifiers 10
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
David J Pinnelas 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.
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.
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Coronary angioplasty and stenting
Electrocardiogram (ecg) 1 to 3 leads with review by physician
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Established patient office or other outpatient visit, 40-54 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Heart rhythm recording, analysis, report, review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection, regadenoson, 0.1 mg
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Technetium tc-99m sestamibi, diagnostic, per study dose
Technetium tc-99m tetrofosmin, diagnostic, per study dose
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart, follow-up
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.
This service was performed 16 times for 15 patientsCoronary angioplasty and stenting is a procedure to open narrowed or blocked heart arteries. A thin tube is inserted into a blood vessel, usually in the leg or arm, and guided to the heart. A small balloon at the end of the tube is inflated to widen the artery. A stent, a small wire mesh tube, may be placed in the artery to keep it open.
This service was performed for 1-10 patientsAn Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. It uses 1 to 3 leads (sensors) placed on your skin. A physician reviews the results to assess heart rate, rhythm, and detect any abnormalities.
This service was performed 61 times for 60 patientsAn Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. In a 2-day continuous ECG, sensors attached to your chest monitor your heart's rhythm over 48 hours. A healthcare professional then reviews the data to identify any irregularities.
This service was performed 49 times for 43 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 31 times for 30 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 932 times for 371 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 35 times for 35 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 35 times for 33 patientsAn exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
This service was performed 53 times for 53 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 819 times for 407 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 32 times for 24 patientsThis procedure involves wearing a device for up to 7 days to continuously record your heart's electrical activity. The data collected helps in understanding your heart's rhythm and detecting irregularities if any. The results are then analyzed, reported, and interpreted by experts.
This service was performed 36 times for 34 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 287 times for 261 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 29 times for 29 patientsRegadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
This service was performed 116 times for 29 patientsThis procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.
This service was performed 33 times for 33 patientsThis 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 19 times for 19 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 27 times for 27 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 46 times for 46 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 574 times for 360 patientsTechnetium Tc-99m Sestamibi is a diagnostic test used to create images of your heart or breast tissues. It involves a safe radioactive substance injection that helps doctors to detect any abnormalities or changes in these tissues.
This service was performed 16 times for 16 patientsTechnetium Tc-99m Tetrofosmin is a radiopharmaceutical used in diagnostic imaging. It helps highlight areas of concern in the heart by emitting signals captured by a special camera. This assists doctors in detecting heart conditions.
This service was performed 30 times for 30 patientsAn ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
This service was performed 56 times for 56 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 213 times for 210 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 137 times for 135 patientsA follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
This service was performed 18 times for 18 patientsThis 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 41 times for 41 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.08 for a new patient copayment and $19.11 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 07753 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.34
- Minimum New Patient Price $61.59
- Maximum New Patient Price $185.05
- Average New Patient Copayment $35.08
- Minimum New Patient Copayment $15.39
- Maximum New Patient Copayment $46.26
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.45
- Minimum Established Patient Price $20.08
- Maximum Established Patient Price $150.98
- Average Established Patient Copayment $19.11
- Minimum Established Patient Copayment $5.02
- Maximum Established Patient Copayment $37.74
* 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 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 comprises 40% of a provider's final MIPS score.
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 comprises 25% of a provider's final MIPS score.
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 comprises 15% of a provider's final MIPS score.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score. -
Cost Score: N/A
The Cost performance category assesses 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 comprises 20% of a provider's final MIPS score.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Pinnelas is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| COMMUNITY MEDICAL CENTER | 99 RT 37 WEST TOMS RIVER, NJ 08755 | (732) 557-8000 | Acute Care Hospitals | |
| OCEAN MEDICAL CENTER | 425 JACK MARTIN BLVD BRICK, NJ 08724 | (732) 840-2200 | Acute Care Hospitals | |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER | 1945 STATE ROUTE 33 NEPTUNE, NJ 07753 | (732) 775-5500 | Acute Care Hospitals | |
| CENTRASTATE MEDICAL CENTER | 901 WEST MAIN STREET FREEHOLD, NJ 07728 | (732) 294-7012 | Acute Care Hospitals |
Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
NEPTUNE, NJ 07753
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982683025, enumerated as an "individual" on January 16, 2006.
The provider is located at 1820 STATE ROUTE 33 SUITE 4B NEPTUNE, NJ 07753 and the phone number is (732) 776-8500.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to verify.
David Pinnelas is affiliated with: COMMUNITY MEDICAL CENTER, OCEAN MEDICAL CENTER, JERSEY SHORE UNIVERSITY MEDICAL CENTER and CENTRASTATE MEDICAL CENTER.
