THEERAPOL PRASERTSUNTARASAI MD
NPI 1245373380
Internal Medicine - Rheumatology in Lubbock, TX

Medicare Participation & PECOS Enrollment Status

Theerapol Prasertsuntarasai 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.

Theerapol Prasertsuntarasai 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: 6901951300

  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: I20170719002483

  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.

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 276 times for 70 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 327 times for 64 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 83 times for 39 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 388 times for 182 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 246 times for 148 patients

Hyaluronan or derivative, monovisc, for intra-articular injection, per dose

Monovisc is a treatment involving an injection of hyaluronan or its derivative into a joint, often the knee. This substance, found naturally in joint fluid, helps lubricate and cushion the joint. The injection can help ease pain, improve mobility, and reduce inflammation caused by arthritis.

This service was performed 52 times for 25 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 165 times for 99 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 3,600 times for 40 patients

Injection, diphenhydramine hcl, up to 50 mg

Diphenhydramine HCL injection is a medicine given to alleviate symptoms of allergies, colds, or hay fever. It can also help with motion sickness and certain symptoms of Parkinson's disease. Up to 50 mg may be administered depending on your condition.

This service was performed 49 times for 24 patients

Injection, infliximab, excludes biosimilar, 10 mg

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

This service was performed 8,756 times for 39 patients

Injection, methylprednisolone acetate, 40 mg

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

This service was performed 52 times for 24 patients

Injection, methylprednisolone acetate, 80 mg

Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.

This service was performed 100 times for 62 patients

Injection, methylprednisolone sodium succinate, up to 125 mg

Methylprednisolone sodium succinate is a steroid medication injected into a muscle or vein. It helps reduce inflammation and immune response. It's used for various conditions like allergies, arthritis, breathing problems, or skin diseases. It's important to follow your doctor's instructions.

This service was performed 51 times for 24 patients

Injection, rituximab, 10 mg

Rituximab is a medication given via injection. It's used to treat certain types of cancer and autoimmune diseases. The 10 mg dosage refers to the amount of the drug in the injection. It works by targeting and destroying specific cells, helping your body's immune system.

This service was performed 5,420 times for 25 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 111 times for 111 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.6 for a new patient copayment and $24.26 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 79424 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. Theerapol Prasertsuntarasai 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 1245373380 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 3 providers are registered at the same or nearby location.

Frequently Asked Questions