DR. JEFFERY ALLEN PROSSER M.D.
NPI 1023154515
Family Medicine in Tarpon Springs, FL

Medicare Participation & PECOS Enrollment Status

Jeffery Prosser is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jeffery Prosser is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 1658393871

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20051230000408

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

• DME-Wheelchairs (DD000N)

  Standard wheelchair (HCPCS:K0001)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient custodial care facility, group care, or assisted living visit, typically 1 hour

This service involves a healthcare professional visiting an established patient in a group care facility or assisted living for about an hour. The visit may include health checks, medication management, and addressing any health concerns to maintain the patient's well-being.

This service was performed 97 times for 14 patients

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 248 times for 16 patients

Extended patient service without direct patient contact, first hour

Extended patient service without direct contact refers to a healthcare service where professionals spend time reviewing your health records, consulting with other providers, or planning your care without you being present, for the first hour.

This service was performed 78 times for 16 patients

Injection of drug or substance into vein

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

This service was performed 250 times for 15 patients

Injection, calcium gluconate, per 10 ml

Calcium gluconate injection is a treatment to correct low calcium levels in your blood. It's administered through a needle into a vein or muscle. Each 10ml dose helps to maintain heart function, nerve transmission, and blood clotting.

This service was performed 839 times for 15 patients

Injection, magnesium sulfate, per 500 mg

Magnesium sulfate injection, per 500 mg, is a medication administered to manage certain health conditions. It aids in controlling seizures in conditions like eclampsia and in managing severe asthma attacks. It's also used to prevent premature labor in pregnant women.

This service was performed 592 times for 15 patients

Injection, pyridoxine hcl, 100 mg

Pyridoxine HCL, also known as Vitamin B6, is administered through an injection, typically for those with a deficiency. This vitamin helps the body produce proteins, hormones, and neurotransmitters. It can also support brain development and function.

This service was performed 250 times for 15 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

This service was performed 171 times for 15 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.9 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 34689 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jeffery Prosser is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1023154515 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions