National Provider Identifier [NPI]: |
1154328177 |
Last Name Of The Provider |
ISENBERG |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
450 HICKORYNUT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OLDSMAR |
Zip Code Of The Provider |
346772017 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
5737 |
Number Of Medicare Beneficiaries |
1308 |
Total Submitted Charge Amount |
332340 |
Total Medicare Allowed Amount |
290990.07 |
Total Medicare Payment Amount |
222966.92 |
Total Medicare Standardized Payment Amount |
223791.17 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
262 |
Number Of Beneficiaries Age 65 to 74 |
213 |
Number Of Beneficiaries Age 75 to 84 |
326 |
Number Of Beneficiaries Age Greater 84 |
507 |
Number Of Female Beneficiaries |
828 |
Number Of Male Beneficiaries |
480 |
Number Of Non Hispanic White Beneficiaries |
1055 |
Number Of Black or African American Beneficiaries |
223 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
648 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
660 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
54 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8339 |