DR. MARY FRANCES PILCHER
NPI 1033352695
Dermatology - MOHS-Micrographic Surgery in Fort Myers, FL

Medicare Participation & PECOS Enrollment Status

Mary Pilcher 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.

Mary Pilcher 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: 6305961533

  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: I20151006002276

  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

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.

Biopsy of related skin growth, each additional growth

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

This service was performed 44 times for 15 patients

Biopsy of related skin growth, first growth

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

This service was performed 54 times for 42 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size is between 1.1-2.5 cm. This repair may involve multiple layers of sutures and could require reconstruction of the skin.

This service was performed 26 times for 26 patients

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

This procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.

This service was performed 71 times for 66 patients

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

This is a procedure to repair a complex wound on your scalp, arm, or leg that is 2.6-7.5 cm long. It involves cleaning, removing damaged tissue, and stitching the wound to promote healing. It's performed under local or general anesthesia.

This service was performed 137 times for 104 patients

Complicated repair of wound of trunk, 2.6-7.5 cm

This service involves the intricate repair of a wound on your body's main structure, between your neck and limbs. The wound measures 2.6-7.5 cm. The procedure includes deep-layer stitching and may involve repairing damaged tissue.

This service was performed 21 times for 21 patients

Destruction of precancer skin growth, 1 growth

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

This service was performed 64 times for 55 patients

Destruction of precancer skin growth, 2-14 growths

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

This service was performed 127 times for 32 patients

Destruction of skin growth, 1-14 growths

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

This service was performed 18 times for 16 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 36 times for 29 patients

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.

This service was performed 17 times for 17 patients

Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less

This procedure involves repairing a wound on your face, ears, eyelids, nose, lips, or mouth. The wound is 2.5 cm or less in size. The repair process includes cleaning, treating, and stitching the wound to promote optimal healing. It's a standard, safe procedure.

This service was performed 15 times for 14 patients

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm

This procedure involves the repair of a wound between 2.6-7.5 cm located on the scalp, underarms, trunk, arms, or legs. The process includes cleaning, debridement (removal of damaged tissue), and suturing (stitching) of the wound to promote healing.

This service was performed 22 times for 22 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 737 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks

This procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.

This service was performed 542 times for 402 patients

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks

This procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.

This service was performed 420 times for 255 patients

Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks

This procedure involves the removal of a growth from your trunk, arms, or legs. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to identify any abnormalities. This helps in diagnosing and planning further treatment.

This service was performed 230 times for 149 patients

Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks

This procedure involves removing growths from the trunk, arms, or legs. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any abnormalities. This aids in diagnosing and treating your condition effectively.

This service was performed 103 times for 56 patients

Repair of wound by transferring skin, 30.1-60.0 sq cm

This procedure involves repairing a wound by moving healthy skin from one area of the body to the wound site. The transferred skin, measuring between 30.1-60.0 square cm, aids in healing and reduces scarring.

This service was performed 112 times for 91 patients

Repair of wound by transferring skin, each additional 30.0 sq cm

This procedure involves the transfer of skin from a healthy area to a wounded area, helping in its healing. Each session covers 30.0 sq cm. It's a common method for treating large wounds, burns, or areas with significant tissue damage.

This service was performed 36 times for 21 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 55 times for 53 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by transferring skin from another part of the body. The size of the skin transferred will be between 10.1 to 30.0 square centimeters. It is performed to restore function and appearance.

This service was performed 49 times for 49 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on various body parts by transferring skin from another area. The transferred skin, up to 10.0 sq cm, helps to cover the wound, promoting healing and reducing scarring. It's a common method for treating larger or deeper wounds.

This service was performed 52 times for 50 patients

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on specified body areas by transferring skin from another part of the body. The transferred skin, measuring between 10.1 to 30.0 square cm, aids in healing the wound and restoring the skin's normal function.

This service was performed 107 times for 96 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on your scalp, arm, or leg by transferring a small piece of skin, 10.0 sq cm or less, from a different area of your body. This skin graft helps promote healing and minimizes scarring.

This service was performed 26 times for 25 patients

Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm

This procedure involves repairing a wound on your scalp, arm, or leg by moving skin from another part of your body. The skin transferred will cover an area between 10.1 to 30.0 square cm. This helps promote healing and reduce scarring.

This service was performed 58 times for 48 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.92 for a new patient copayment and $18.25 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 33912 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 86.06, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 86.06 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 99.19

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: 100

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 40

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: 54.35

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: 54.35

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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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 1033352695 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 6 providers are registered at the same or nearby location.

Frequently Asked Questions