SHARON A GOBLE M.D.
NPI 1255394417
Internal Medicine - Hematology & Oncology in Richmond, VA

Medicare Participation & PECOS Enrollment Status

Sharon Goble 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.

Sharon Goble 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: 7315027927

  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: I20100330000876

  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.

Unknown

• Treatment-Treatment - Miscellaneous (RX029N)

  Capecitabine, oral, 150 mg (HCPCS:J8520)

  1 DME suppliers used 11 Medicare Claims 476 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Capecitabine, oral, 500 mg (HCPCS:J8521)

  1 DME suppliers used 60 Medicare Claims 4850 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period (HCPCS:Q0511)

  1 DME suppliers used 39 Medicare Claims 39 Services Paid

• Treatment-Chemotherapy (RH012N)

  Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period (HCPCS:Q0512)

  1 DME suppliers used 28 Medicare Claims 32 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.

Administration of additional new drug or substance into vein using push technique

This procedure involves injecting a new medication or substance directly into your vein using a method called the 'push' technique. It's a quick way to deliver medication into your bloodstream for fast-acting relief or treatment.

This service was performed 43 times for 16 patients

Administration of additional new drug or substance into vein, 1 hour or less

This procedure involves introducing a new drug or substance into your vein, typically via an IV drip. It lasts for an hour or less. This method allows the substance to quickly reach your bloodstream, ensuring rapid and effective treatment.

This service was performed 65 times for 30 patients

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 340 times for 128 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 137 times for 34 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

This service was performed 79 times for 11 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

This service was performed 63 times for 20 patients

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. In the office, a pump is used to start an intravenous infusion of these drugs. The infusion can then be continued at home or another setting, like a rest home.

This service was performed 33 times for 12 patients

Drawing of blood for a medical problem

Drawing blood is a simple procedure where a needle is inserted into a vein, usually in your arm, to collect a small sample. This sample helps in diagnosing any medical issues you may have. You might feel a small prick, but overall, it's a quick and safe process.

This service was performed 23 times for 14 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 470 times for 318 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 506 times for 216 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 17 times for 15 patients

Follow-up hospital inpatient care per day, typically 15 minutes

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

This service was performed 49 times for 30 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 102 times for 56 patients

Infusion into a vein for hydration, 31-60 minutes

This is a procedure where a sterile solution is administered into your vein to help restore body fluid balance. It typically lasts between 31-60 minutes. It's a safe, common treatment for dehydration or to deliver medication.

This service was performed 41 times for 38 patients

Infusion into a vein for hydration, each additional hour

This procedure involves delivering fluids directly into your vein to keep your body hydrated. It is typically done when oral hydration is insufficient. Each additional hour means more fluid is infused to ensure adequate hydration.

This service was performed 52 times for 34 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

This service was performed 88 times for 62 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

This service was performed 25 times for 14 patients

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour

This procedure involves delivering medication, fluids, or nutrients directly into your vein. This is done to treat, prevent, or diagnose various conditions. Each additional hour refers to the extended time you may need to receive these substances for optimal results.

This service was performed 55 times for 18 patients

Infusion, normal saline solution , 1000 cc

An infusion of normal saline solution, 1000 cc, is a common medical procedure. It involves introducing a saltwater solution into your bloodstream via an intravenous (IV) line. This helps to hydrate your body, correct electrolyte imbalances, and deliver medications if needed.

This service was performed 54 times for 47 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 25 times for 25 patients

Injection of additional new drug or substance into vein

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

This service was performed 257 times for 69 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 31 times for 24 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 196 times for 73 patients

Injection, bortezomib (velcade), 0.1 mg

Bortezomib (Velcade) is a medication administered through an injection. It's used to treat multiple myeloma and mantle cell lymphoma, types of cancer. It works by blocking certain proteins in cancer cells, slowing their growth.

This service was performed 1,137 times for 13 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 7,500 times for 27 patients

Injection, dexamethasone sodium phosphate, 1 mg

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

This service was performed 1,455 times for 56 patients

Injection, epoetin alfa, (for non-esrd use), 1000 units

Epoetin alfa is a medication injected to help your body produce more red blood cells, improving energy levels and reducing tiredness. It's often used for patients with certain types of anemia. Each injection contains 1000 units of the medicine.

This service was performed 1,740 times for 16 patients

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use)

Ferumoxytol injection is a treatment for iron deficiency anemia, a condition where your body lacks enough iron. It is injected into your vein to increase iron levels, aiding in the production of healthy red blood cells. This treatment is not for ESRD patients.

This service was performed 24,990 times for 37 patients

Injection, fluorouracil, 500 mg

Fluorouracil is a chemotherapy drug, given as an injection to treat various types of cancer. The 500 mg dose helps to stop cancer cells from growing and multiplying. You might feel some side effects, but these are typically manageable.

This service was performed 332 times for 12 patients

Injection, granisetron hydrochloride, 100 mcg

Granisetron hydrochloride is an anti-nausea medication given by injection. It helps prevent nausea and vomiting often caused by cancer treatments like chemotherapy. Its dosage is measured in micrograms (mcg).

This service was performed 370 times for 20 patients

Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg

The Gammagard Liquid injection is a type of immune globulin therapy. It's used to boost your body's immune system, helping it fight off infections. The therapy involves injecting a liquid form of proteins, collected from healthy donors, into your body. This is a 500mg dose.

This service was performed 1,550 times for 11 patients

Injection, nivolumab, 1 mg

Nivolumab is a medication given via injection, often used in cancer treatment. It works by helping your immune system fight the cancer cells. The dosage is measured in milligrams (mg), with 1 mg being a common dose.

This service was performed 13,300 times for 16 patients

Injection, paclitaxel, 1 mg

Paclitaxel is a medication administered via injection to treat various types of cancer. It works by inhibiting cell division, thus preventing cancer cells from growing and multiplying. Each dose is tailored to the patient's body size.

This service was performed 4,890 times for 12 patients

Injection, palonosetron hcl, 25 mcg

Palonosetron HCL is an injection used to prevent nausea and vomiting caused by chemotherapy. It works by blocking a natural substance (serotonin) in the body that can cause vomiting. This helps improve your comfort during cancer treatment.

This service was performed 450 times for 17 patients

Injection, pegfilgrastim-bmez, biosimilar, (ziextenzo), 0.5 mg

Pegfilgrastim-bmez (Ziextenzo) is a medicine given via injection. It's a biosimilar, meaning it's very similar to a biological medicine already approved. It helps boost white blood cells, aiding your body to fight infections after treatments that can lower these cells, like chemotherapy.

This service was performed 372 times for 16 patients

Injection, pembrolizumab, 1 mg

Pembrolizumab is a medication given via injection to help your body's immune system fight certain types of cancer. It's typically administered in a hospital or clinic by a healthcare professional.

This service was performed 6,000 times for 15 patients

Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromise

Tixagevimab and cilgavimab injection is a preventive treatment for certain adults and children (12+ years, weighing 40kg+) with compromised health conditions. It's used when there's no known exposure to SARS-CoV-2, to help their bodies better fend off potential infections.

This service was performed 14 times for 12 patients

Injection, tixagevimab and cilgavimab, for the pre-exposure prophylaxis only, for certain adults and pediatric individuals (12 years of age and older weighing at least 40kg) with no known sars-cov-2 exposure, who either have moderate to severely compromise

Tixagevimab and cilgavimab are drugs administered via injection for pre-exposure protection against SARS-CoV-2. This is for people aged 12 and above, weighing 40kg or more, with no known virus exposure but have moderate to severe health compromises.

This service was performed 14 times for 12 patients

Injection, zoledronic acid, 1 mg

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

This service was performed 139 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 45 times for 45 patients

Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation a

The Oncology Care Model (OCM) Monthly Enhanced Oncology Services (MEOS) payment, denoted by G9678, is a compensation method for OCM practitioners. These payments are specifically for providing additional, or "enhanced", services to OCM beneficiaries, as outlined in the OCM participation agreement.

This service was performed 170 times for 59 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $42.57 for a new patient copayment and $24.78 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 23235 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 69.96, 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: 69.96 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: 58.47

  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: 79

  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: 52.61

  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: 52.61

  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.

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. Sharon Goble 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 1255394417 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

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The following 20 providers are registered at the same or nearby location.

Frequently Asked Questions