National Provider Identifier [NPI]: |
1821053232 |
Last Name Of The Provider |
AL-SULLAMI |
First Name Of The Provider |
HUSSAIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MSPT |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6851 JERICHO TPKE |
Street Address 2 Of The Provider |
STE 235 |
City Of The Provider |
SYOSSET |
Zip Code Of The Provider |
11791 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
2054 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
163620 |
Total Medicare Allowed Amount |
61666.78 |
Total Medicare Payment Amount |
47528 |
Total Medicare Standardized Payment Amount |
37016.54 |
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 |
9 |
Number Of Medical Services |
2054 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
163620 |
Total Medical Medicare Allowed Amount |
61666.78 |
Total Medical Medicare Payment Amount |
47528 |
Total Medical Medicare Standardized Payment Amount |
37016.54 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
55 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
88 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
15 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.901 |