| National Provider Identifier [NPI]: | 1366453680 |
| Last Name Of The Provider | ISRAEL |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D., F.A.C.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 DEVINE STREET |
| Street Address 2 Of The Provider | SUITE # 1 |
| City Of The Provider | NORTH HAVEN |
| Zip Code Of The Provider | 06473 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 670 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 332246 |
| Total Medicare Allowed Amount | 78731.46 |
| Total Medicare Payment Amount | 59021.11 |
| Total Medicare Standardized Payment Amount | 55927.03 |
| 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 | 49 |
| Number Of Medical Services | 670 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 332246 |
| Total Medical Medicare Allowed Amount | 78731.46 |
| Total Medical Medicare Payment Amount | 59021.11 |
| Total Medical Medicare Standardized Payment Amount | 55927.03 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 220 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 208 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7303 |