National Provider Identifier [NPI]: |
1023273190 |
Last Name Of The Provider |
GOLDSTEIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
510 HICKSVILLE ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MASSAPEQUA |
Zip Code Of The Provider |
11758 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
108 |
Number Of Services |
7620 |
Number Of Medicare Beneficiaries |
1079 |
Total Submitted Charge Amount |
1702307.58 |
Total Medicare Allowed Amount |
628737.5 |
Total Medicare Payment Amount |
484872.31 |
Total Medicare Standardized Payment Amount |
425011.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
232 |
Number Of Medicare Beneficiaries With Drug Services |
73 |
Total Drug Submitted ChargeAmount |
12182 |
Total Drug Medicare AllowedAmount |
11456.34 |
Total Drug Medicare PaymentAmount |
9116 |
Total Drug Medicare Standardized Payment Amount |
9116 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
103 |
Number Of Medical Services |
7388 |
Number Of Medicare Beneficiaries With Medical Services |
1079 |
Total Medical Submitted Charge Amount |
1690125.58 |
Total Medical Medicare Allowed Amount |
617281.16 |
Total Medical Medicare Payment Amount |
475756.31 |
Total Medical Medicare Standardized Payment Amount |
415895.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
424 |
Number Of Beneficiaries Age 75 to 84 |
352 |
Number Of Beneficiaries Age Greater 84 |
208 |
Number Of Female Beneficiaries |
526 |
Number Of Male Beneficiaries |
553 |
Number Of Non Hispanic White Beneficiaries |
999 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
24 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1003 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4033 |