National Provider Identifier [NPI]: |
1225074586 |
Last Name Of The Provider |
NOWAK |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 NORTH BROADWAY |
Street Address 2 Of The Provider |
PHELPS MEMORIAL HOSPITAL |
City Of The Provider |
SLEEPY HOLLOW |
Zip Code Of The Provider |
10591 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
667 |
Number Of Medicare Beneficiaries |
580 |
Total Submitted Charge Amount |
547720 |
Total Medicare Allowed Amount |
102231.1 |
Total Medicare Payment Amount |
77368.95 |
Total Medicare Standardized Payment Amount |
69035.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
667 |
Number Of Medicare Beneficiaries With Medical Services |
580 |
Total Medical Submitted Charge Amount |
547720 |
Total Medical Medicare Allowed Amount |
102231.1 |
Total Medical Medicare Payment Amount |
77368.95 |
Total Medical Medicare Standardized Payment Amount |
69035.8 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
191 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
461 |
Number Of Black or African American Beneficiaries |
59 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
405 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
175 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
38 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8886 |