| National Provider Identifier [NPI]: | 1700082740 |
| Last Name Of The Provider | SHEPARD |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 1ST AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100166402 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 239 |
| Number Of Services | 9686 |
| Number Of Medicare Beneficiaries | 5005 |
| Total Submitted Charge Amount | 1010067.77 |
| Total Medicare Allowed Amount | 309915.36 |
| Total Medicare Payment Amount | 241580.47 |
| Total Medicare Standardized Payment Amount | 238781.74 |
| 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 | 239 |
| Number Of Medical Services | 9686 |
| Number Of Medicare Beneficiaries With Medical Services | 5005 |
| Total Medical Submitted Charge Amount | 1010067.77 |
| Total Medical Medicare Allowed Amount | 309915.36 |
| Total Medical Medicare Payment Amount | 241580.47 |
| Total Medical Medicare Standardized Payment Amount | 238781.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1229 |
| Number Of Beneficiaries Age 65 to 74 | 1578 |
| Number Of Beneficiaries Age 75 to 84 | 1313 |
| Number Of Beneficiaries Age Greater 84 | 885 |
| Number Of Female Beneficiaries | 3086 |
| Number Of Male Beneficiaries | 1919 |
| Number Of Non Hispanic White Beneficiaries | 4500 |
| Number Of Black or African American Beneficiaries | 205 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 166 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 82 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3122 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1883 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5632 |