| National Provider Identifier [NPI]: | 1427108737 |
| Last Name Of The Provider | SHEPHERD |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 660 1ST AVE |
| Street Address 2 Of The Provider | NEURORADIOLOGY SECTION, NYU LANGONE MEDICAL CENTER |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100163295 |
| 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 | 48 |
| Number Of Services | 10044 |
| Number Of Medicare Beneficiaries | 882 |
| Total Submitted Charge Amount | 1290215 |
| Total Medicare Allowed Amount | 217931.29 |
| Total Medicare Payment Amount | 164561.76 |
| Total Medicare Standardized Payment Amount | 147693.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 8393 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 53700 |
| Total Drug Medicare AllowedAmount | 3734.11 |
| Total Drug Medicare PaymentAmount | 2927.55 |
| Total Drug Medicare Standardized Payment Amount | 2927.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1651 |
| Number Of Medicare Beneficiaries With Medical Services | 882 |
| Total Medical Submitted Charge Amount | 1236515 |
| Total Medical Medicare Allowed Amount | 214197.18 |
| Total Medical Medicare Payment Amount | 161634.21 |
| Total Medical Medicare Standardized Payment Amount | 144765.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 330 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 683 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 677 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 205 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.6769 |