| National Provider Identifier [NPI]: | 1255339743 |
| Last Name Of The Provider | KELLY |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 E SUNRISE HWY |
| Street Address 2 Of The Provider | 208 |
| City Of The Provider | LINDENHURST |
| Zip Code Of The Provider | 117572598 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2689 |
| Number Of Medicare Beneficiaries | 1149 |
| Total Submitted Charge Amount | 520348.81 |
| Total Medicare Allowed Amount | 246547.76 |
| Total Medicare Payment Amount | 221132.27 |
| Total Medicare Standardized Payment Amount | 186433.2 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 589 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 1128 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 951 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 951 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 198 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9729 |