| National Provider Identifier [NPI]: | 1154395382 |
| Last Name Of The Provider | FIROUZTALE |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 280 MONTAUK HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAY SHORE |
| Zip Code Of The Provider | 117068403 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 63391 |
| Number Of Medicare Beneficiaries | 997 |
| Total Submitted Charge Amount | 2587018.98 |
| Total Medicare Allowed Amount | 1484047.17 |
| Total Medicare Payment Amount | 1111907.24 |
| Total Medicare Standardized Payment Amount | 1078974.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 60750 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 2075025 |
| Total Drug Medicare AllowedAmount | 1179030.22 |
| Total Drug Medicare PaymentAmount | 885564.73 |
| Total Drug Medicare Standardized Payment Amount | 885564.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 2641 |
| Number Of Medicare Beneficiaries With Medical Services | 997 |
| Total Medical Submitted Charge Amount | 511993.98 |
| Total Medical Medicare Allowed Amount | 305016.95 |
| Total Medical Medicare Payment Amount | 226342.51 |
| Total Medical Medicare Standardized Payment Amount | 193410.11 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 372 |
| Number Of Beneficiaries Age 65 to 74 | 292 |
| Number Of Beneficiaries Age 75 to 84 | 222 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 586 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 844 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 360 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 1.5399 |