| National Provider Identifier [NPI]: | 1609948884 |
| Last Name Of The Provider | SISSELMAN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 VETERANS BLVD |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | MASSAPEQUA |
| Zip Code Of The Provider | 117584944 |
| 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 | 74 |
| Number Of Services | 4423 |
| Number Of Medicare Beneficiaries | 359 |
| Total Submitted Charge Amount | 557073 |
| Total Medicare Allowed Amount | 310123.09 |
| Total Medicare Payment Amount | 235368.05 |
| Total Medicare Standardized Payment Amount | 209397.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 10085 |
| Total Drug Medicare AllowedAmount | 5744.68 |
| Total Drug Medicare PaymentAmount | 5514.51 |
| Total Drug Medicare Standardized Payment Amount | 5514.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 4152 |
| Number Of Medicare Beneficiaries With Medical Services | 359 |
| Total Medical Submitted Charge Amount | 546988 |
| Total Medical Medicare Allowed Amount | 304378.41 |
| Total Medical Medicare Payment Amount | 229853.54 |
| Total Medical Medicare Standardized Payment Amount | 203883.04 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 189 |
| Number Of Non Hispanic White Beneficiaries | 327 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0411 |