DR. KENNEDY YALAMANCHILI MD
NPI 1205825932
Specialist in Newark, DE

Medicare Participation & PECOS Enrollment Status

Kennedy Yalamanchili 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.

Kennedy Yalamanchili 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: 4688626518

  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: I20110210000376, I20140115000277

  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-Other DME (DE000N)

  Osteogenesis stimulator, electrical, non-invasive, spinal applications (HCPCS:E0748)

  1 DME suppliers used 55 Medicare Claims 55 Services Paid

Orthotic Devices

• DME-Orthotic Devices (DF000N)

  Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf (HCPCS:L0174)

  1 DME suppliers used 11 Medicare Claims 11 Services Paid

• DME-Orthotic Devices (DF007N)

  Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf (HCPCS:L0650)

  1 DME suppliers used 40 Medicare Claims 40 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.

Biopsy of middle spine bone

A biopsy of the middle spine bone is a procedure where a small piece of bone or tissue is removed from your spine. This sample is then examined under a microscope to check for diseases or conditions. It's a safe procedure that helps doctors diagnose your health issue accurately.

This service was performed 12 times for 12 patients

Biopsy of upper or lower spine bone

A biopsy of the spine bone is a procedure where a small sample of your spine bone is removed for testing. It helps doctors diagnose conditions like infections or cancer. You'll be given local or general anesthesia to numb the area or put you to sleep, ensuring comfort.

This service was performed 18 times for 18 patients

Burr hole for insertion of brain tube or monitoring device

A Burr Hole procedure involves creating a small opening in the skull to relieve pressure, drain fluid, or insert a monitoring device. It's a common neurosurgical method used to treat various brain conditions in a safe and effective manner.

This service was performed 15 times for 15 patients

Computer-assisted spinal procedure

A computer-assisted spinal procedure is a surgical technique that uses computer technology for improved precision. It involves creating a 3D image of your spine to guide the surgeon during the operation. This method enhances accuracy, reduces risk, and promotes quicker recovery.

This service was performed 37 times for 35 patients

Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming

This procedure involves electronically analyzing an implanted neurostimulator. This device sends electrical pulses to your spinal cord or peripheral nerves to manage pain. The programming is complex, requiring expert analysis to ensure proper functioning.

This service was performed 26 times for 22 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 156 times for 144 patients

Exploration of spine fusion

Exploration of spine fusion is a procedure to examine a previously performed spinal fusion surgery. The process checks the success of the fusion or finds potential issues, such as hardware failure or non-union of the fused vertebrae. It's a diagnostic tool to ensure healing.

This service was performed 38 times for 38 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 60 times for 39 patients

Fusion of additional segment of spine

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

This service was performed 210 times for 95 patients

Fusion of spine in lower back

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

This service was performed 77 times for 76 patients

Fusion of spine in upper back

Fusion of the spine in the upper back, also known as thoracic spinal fusion, is a surgical procedure aimed at connecting two or more vertebrae. This is done to improve stability, correct a deformity, or reduce pain by eliminating motion between the fused vertebrae.

This service was performed 12 times for 12 patients

Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc

This procedure involves fusing together the bones in the upper spine to stabilize it. A disc is removed to ease pressure on the spinal cord or nerve. This helps reduce pain and improve mobility. This is a common treatment for certain spinal conditions.

This service was performed 23 times for 23 patients

Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc

This is a surgical procedure where the upper spine bones are joined together after removing a disc. This helps to relieve pressure on the spinal cord or nerves. If more discs need to be removed, the same process is repeated for each additional disc.

This service was performed 27 times for 14 patients

Graft of donor bone to spine

A graft of donor bone to the spine is a procedure where a piece of bone from a donor is attached to your spine to help it heal or improve its structure. This is often done to strengthen the spine or aid in recovery from injury or disease.

This service was performed 106 times for 105 patients

Harvest of bone for spine surgery graft

Harvest of bone for spine surgery graft involves taking a small piece of bone from one area of your body, often the hip, to use in your spine surgery. This bone graft helps promote healing and stability in the spine by providing a framework for new, natural bone to grow on.

This service was performed 92 times for 91 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 100 times for 99 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

This service was performed 76 times for 59 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 26 times for 25 patients

Insertion, revision, or repositioning of spinal canal tube for medication administration with removal of spine bone

This procedure involves placing, adjusting, or repositioning a tube in your spinal canal to administer medication. It may require removal of a small portion of spinal bone for access. This is done to effectively deliver medicine directly to your spine.

This service was performed 37 times for 37 patients

Laminectomy or laminotomy (partial removal of spine bones)

A laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.

This service was performed for 120 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 83 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 441 times for 441 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 21 times for 21 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

This service was performed 63 times for 30 patients

Placement of stabilizing device to back, 3-6 spine bone segments

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

This service was performed 65 times for 64 patients

Placement of stabilizing device to front, 2-3 spine bone segments

This procedure involves positioning a stabilizing device on the front of 2-3 segments of your spine. It's designed to provide support and stability to your spine, potentially alleviating discomfort and improving mobility.

This service was performed 21 times for 21 patients

Release of lower spinal cord and/or nerves, single segment

This procedure involves freeing the lower spinal cord or nerves from any compression in a single segment. It can alleviate pain or discomfort, improve mobility, and enhance overall quality of life. This is performed by a skilled surgeon under anesthesia.

This service was performed 64 times for 64 patients

Release of middle or lower spinal cord and/or nerves, single segment

This procedure involves relieving pressure on the middle or lower spinal cord or nerves. A single section of the spine is focused on. It can help reduce pain, improve mobility, and enhance overall quality of life.

This service was performed 140 times for 73 patients

Release of middle spinal cord and/or nerves, single segment

This procedure involves relieving pressure on the middle section of the spinal cord or nerves. It focuses on a single segment of the spine. The goal is to alleviate pain or discomfort, and potentially improve mobility and overall quality of life.

This service was performed 13 times for 13 patients

Removal of skull bone for aspiration of blood accumulation in upper brain outside or below brain membrane

This procedure involves removing a section of the skull to access and remove accumulated blood in the upper brain. This blood could be either outside or beneath the brain membrane. The goal is to alleviate pressure and promote brain health.

This service was performed 12 times for 12 patients

Removal of spine bone for insertion of neurostimulator electrode plate in spine

This procedure involves removing a small part of the spine bone to place a neurostimulator electrode plate. This device can help manage pain signals from the spine to the brain, improving comfort and quality of life. The process is performed by skilled surgeons in a safe environment.

This service was performed 13 times for 13 patients

Removal or revision of neurostimulator generator or receiver

The procedure involves the removal or revision of a neurostimulator generator or receiver, a device implanted under the skin to send electrical pulses to the brain or spinal cord. This helps manage chronic pain or neurological disorders. The procedure might be needed if the device malfunctions, or to replace its battery.

This service was performed 16 times for 16 patients

Repair of wound of trunk by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on your body's trunk area (chest, abdomen, or back) using a skin graft. A piece of healthy skin, typically 10.0 square cm or less, is taken from another area of your body and transplanted to the wound site to aid healing.

This service was performed 29 times for 27 patients

Repair of wound of trunk by transferring skin, 10.1-30.0 sq cm

This procedure involves treating a wound on the body by moving skin from one area to another. The transferred skin, ranging from 10.1-30.0 sq cm, helps cover and heal the wound. It's a common way to promote healing for large or deep wounds.

This service was performed 39 times for 39 patients

Review by radiologist of ct guidance for needle placement

This process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.

This service was performed 51 times for 48 patients

Self soft tissue graft

A self soft tissue graft is a dental procedure where tissue from your own mouth is used to treat areas with gum recession. This can protect roots, reduce sensitivity, and improve gum health. It's a common, safe procedure.

This service was performed 90 times for 89 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 159 patients

Treatment of broken lower spine bone with placement of stabilizing device

This procedure involves fixing a broken bone in the lower spine. A stabilizing device is inserted to support the bone, promoting healing and reducing pain. The device helps to maintain proper spinal alignment and stability during your recovery period.

This service was performed 12 times for 12 patients

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance

This procedure treats a broken bone in the middle of your spine. A stabilizing device is placed to support the damaged area. Imaging guidance, like X-rays, is used to ensure precise placement of the device. This aids in your recovery and helps maintain spine stability.

This service was performed 20 times for 20 patients

Treatment of broken or dislocated lower spine bone

The treatment of a broken or dislocated lower spine bone involves realigning the bone and maintaining its position until it heals. This may require surgery, bracing, or a combination of both. Pain management and physiotherapy are also integral parts of recovery.

This service was performed 45 times for 45 patients

Treatment of broken or dislocated spine bone, each additional segment

Treatment for additional broken or dislocated spine segments involves realigning the bones, often through surgery. This helps restore function and relieve pain. The procedure may include the use of plates, screws or rods to stabilize the spine. After surgery, physical therapy is typically recommended for recovery.

This service was performed 50 times for 24 patients

Treatment of broken spine bone with stabilizing device, each additional segment

This procedure involves the treatment of a fractured spine bone. A stabilizing device is used to support and secure each additional affected segment of the spine. This helps in proper alignment and promotes healing, enhancing your comfort and mobility.

This service was performed 19 times for 11 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 48.45, 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 provider also has detailed performance information the following quality measures: .

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: 48.45 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: 49.23

  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: 0

  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: 62.28

  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: 62.28

  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.

MIPS Quality Measures

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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 1205825932 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions