DEREK SUN MD
NPI 1174898019
Radiology - Body Imaging in San Francisco, CA

Medicare Participation & PECOS Enrollment Status

Derek Sun 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.

Derek Sun 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: 7416195607

  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: I20130529000895

  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.

3d radiographic procedure with computerized image postprocessing

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

This service was performed 35 times for 35 patients

3d radiographic procedure with computerized image postprocessing

A 3D radiographic procedure with computerized image postprocessing is a high-tech imaging test. It uses X-rays to create detailed 3D images of the body. The computerized postprocessing further enhances these images for more precise diagnosis and treatment planning.

This service was performed 68 times for 68 patients

Colonoscopy

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

This service was performed for 1-10 patients

Complete ultrasound scan behind abdominal cavity

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

This service was performed 47 times for 47 patients

Complete ultrasound scan of abdomen

A complete ultrasound scan of the abdomen is a non-invasive imaging procedure. It uses sound waves to produce images of the organs in your abdomen, such as the liver, gallbladder, spleen, pancreas, and kidneys. It helps in diagnosing, monitoring, and planning treatments.

This service was performed 55 times for 54 patients

Complete ultrasound scan of pelvis

A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.

This service was performed 14 times for 14 patients

Ct scan of abdomen and pelvis before and after contrast

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

This service was performed 104 times for 104 patients

Ct scan of abdomen and pelvis before and after contrast

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

This service was performed 27 times for 26 patients

Ct scan of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

This service was performed 553 times for 501 patients

Ct scan of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

This service was performed 77 times for 75 patients

Ct scan of abdomen and pelvis without contrast

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

This service was performed 186 times for 176 patients

Ct scan of abdomen and pelvis without contrast

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

This service was performed 16 times for 16 patients

Ct scan of abdomen before and after contrast

A CT scan of the abdomen before and after contrast is a diagnostic procedure. It involves taking detailed images of your abdomen area. Initially, images are taken without a contrast agent. Then, a contrast dye is given to highlight specific areas inside your body, helping to provide clearer images for better diagnosis.

This service was performed 18 times for 17 patients

Ct scan of blood vessels of abdomen and pelvis with contrast

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

This service was performed 54 times for 54 patients

Ct scan of chest with contrast

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

This service was performed 13 times for 12 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

This service was performed 13 times for 13 patients

Imaging for evaluation of swallowing function

This process, known as a swallowing study, uses imaging technology to view how food and liquid move from your mouth to your stomach. It helps identify any issues you may have swallowing, which can be crucial for determining the best treatment plan.

This service was performed 92 times for 90 patients

Imaging of urinary tract following injection of a contrast agent

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

This service was performed 36 times for 33 patients

Injection, gadoterate meglumine, 0.1 ml

Gadoterate meglumine is a contrast agent used in MRI scans to help visualize certain areas of your body more clearly. It's injected into your bloodstream, typically through a vein in your arm, and helps doctors get more detailed images.

This service was performed 3,889 times for 24 patients

Limited ultrasound scan of joint or other extremity structure lacking blood vessels

A limited ultrasound scan of a joint or other extremity structure lacking blood vessels is a non-invasive procedure that uses sound waves to create images of the inside of your body. This helps in diagnosing and monitoring conditions related to your joints or other similar structures.

This service was performed 12 times for 12 patients

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.

This service was performed 11,350 times for 102 patients

Mri scan of abdomen before and after contrast

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

This service was performed 91 times for 84 patients

Mri scan of abdomen before and after contrast

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

This service was performed 136 times for 128 patients

Mri scan of pelvis before and after contrast

An MRI scan of the pelvis before and after contrast is a non-invasive imaging technique. It uses magnetic fields and radio waves to capture detailed images of your lower abdomen. Contrast dye, safe for the body, improves image clarity. This helps detect abnormalities more accurately.

This service was performed 67 times for 67 patients

Mri scan of pelvis before and after contrast

An MRI scan of the pelvis before and after contrast is a non-invasive imaging technique. It uses magnetic fields and radio waves to capture detailed images of your lower abdomen. Contrast dye, safe for the body, improves image clarity. This helps detect abnormalities more accurately.

This service was performed 149 times for 144 patients

Mri scan of pelvis without contrast

An MRI scan of the pelvis without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed pictures of the lower part of your body. This helps doctors to identify any abnormalities or issues in that area.

This service was performed 11 times for 11 patients

Single contrast x-ray of esophagus

A single contrast x-ray of the esophagus is a non-invasive procedure where a radiopaque substance is swallowed to highlight the esophagus. This allows doctors to capture clear images of the area, aiding in the diagnosis of any abnormalities or issues.

This service was performed 14 times for 13 patients

Single contrast x-ray of upper digestive tract

A single contrast x-ray of the upper digestive tract is a diagnostic procedure that uses a special dye and x-rays to see how your digestive system is functioning. It helps in detecting abnormalities or diseases in your esophagus, stomach, and the first part of your small intestine.

This service was performed 15 times for 12 patients

Ultrasound scan of head and neck soft tissue

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

This service was performed 63 times for 63 patients

Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina

An ultrasound scan of the lower abdominal region is a safe, non-invasive procedure that uses sound waves to create images of internal structures. This helps in checking the health of reproductive organs and detecting any abnormalities. The scan is done via a small probe inserted into the body.

This service was performed 13 times for 13 patients

Ultrasound study of one arm or leg veins with compression and maneuvers

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

This service was performed 12 times for 12 patients

X-ray of abdomen, 1 view

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

This service was performed 836 times for 519 patients

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 76.34, 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: 76.34 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: 77.06

  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: N/A

  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: 52.02

  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: 52.02

  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.

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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 1174898019 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions