DR. FRANK RUIZ MD
NPI 1417967019
Internal Medicine - Gastroenterology in Clifton, NJ
NPI Status: Active since August 08, 2006
Contact Information
925 CLIFTON AVE
CLIFTON, NJ
ZIP 07013
Phone: (973) 458-0408
Fax: (973) 405-6564
- Individual
- Male
- Years of Experience 33
- Internal Medicine
- Gastroenterology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About FRANK RUIZ
This page provides the complete NPI Profile along with additional information for Frank Ruiz, an internist established in Clifton, New Jersey with a medical specialization in Internal Medicine, focusing in gastroenterology and more than 33 years of experience. The healthcare provider is registered in the NPI registry with number 1417967019 assigned on August 2006. The practitioner's primary taxonomy code is 207RG0100X with license number 25MA6384100 (NJ). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1417967019
- Provider Name
- DR. FRANK RUIZ MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 925 CLIFTON AVE CLIFTON, NJ 07013
- Location Phone
- (973) 458-0408
- Location Fax
- (973) 405-6564
- Mailing Address
- 1130 MCBRIDE AVE FL 3 WOODLAND PARK, NJ 07424
- Mailing Phone
- (973) 812-1400
- Mailing Fax
- (973) 405-6564
- Medical School Name
- OTHER
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-08-2006
- Last Update Date
- 08-09-2023
- Code Navigator
An internist like Frank Ruiz is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 71 Union Ave Ste 201
Rutherford, NJ 07070
(201) 842-0020
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Gastroenterology
- Taxonomy Code
- 207RG0100X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA6384100
- License State
- NJ
- Taxonomy Description
- An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7478208 | MEDICAID (05) | NJ |
Medicare Participation & PECOS Enrollment Status
Frank Ruiz 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.
Frank Ruiz 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: 648236810
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: I20120208000694
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 esophagus, stomach, and/or upper small bowel using a flexible endoscope
Biopsy of large bowel using a flexible endoscope
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
Colonoscopy
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Initial hospital inpatient care per day, typically 50 minutes
New patient office or other outpatient visit, 30-44 minutes
Removal of polyps or growths of large bowel using an endoscope with mechanical snare
Upper gastrointestinal (GI) endoscopy for acid reflux
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
This service was performed 50 times for 50 patientsA biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
This service was performed 27 times for 26 patientsChronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
This service was performed 123 times for 13 patientsChronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
This service was performed 66 times for 13 patientsA 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 233 patientsThis 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 150 times for 109 patientsThis 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 61 times for 54 patientsInitial 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 19 times for 18 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 38 times for 38 patientsThis procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
This service was performed 13 times for 13 patientsAn upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.
This service was performed for 157 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.21 for a new patient copayment and $27.89 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 07013 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.86
- Minimum New Patient Price $63.84
- Maximum New Patient Price $190.92
- Average New Patient Copayment $36.21
- Minimum New Patient Copayment $15.96
- Maximum New Patient Copayment $47.73
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $111.57
- Minimum Established Patient Price $20.97
- Maximum Established Patient Price $155.92
- Average Established Patient Copayment $27.89
- Minimum Established Patient Copayment $5.24
- Maximum Established Patient Copayment $38.98
* 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.
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.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Appropriate indication for colonoscopy | 92% | 495 |
| Percentage of colonoscopy procedures performed for an indication that is included in a published standard list of appropriate indications and the indication is documented | ||
| Appropriate management of anticoagulation in the peri-procedural period rate - EGD | 100% | 26 |
| Percentage of patients undergoing an EGD on an anti-platelet agent or an anticoagulant who leave the endoscopy unit with instructions for management of this medication | ||
| Clinical Data Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to a clinical data registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_5_MULTI. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| e-Prescribing | 79% | 305 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Patient-Specific Education | 0% | 420 |
| The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Primary Care Physician and Behavioral Health Bilateral Electronic Exchange of Information for Shared Patients | Yes | N/A |
| The primary care and behavioral health practices use the same electronic health record system for shared patients or have an established bidirectional flow of primary care and behavioral health records. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 71% | 420 |
| For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology. | ||
| Public Health Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit data to public health registries. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_PHCDRR_4_MULTI. | ||
| Secure Messaging | 8% | 420 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative). | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Send a Summary of Care | 23% | 64 |
| For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record. | ||
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. Frank Ruiz is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ST MARY'S GENERAL HOSPITAL | 350 BOULEVARD PASSAIC, NJ 07055 | (973) 365-4300 | Acute Care Hospitals |
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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.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 1 | 7 | 9 | 6 | 7 | 0 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 2 | 7 | 18 | 6 | 14 | 0 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 2 + 7 + 1 + 8 + 6 + 1 + 4 + 0 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1417967019 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1033181680 | DR. AHMED ABDEL MEKKAWY M.D. Individual | Internal Medicine (Pulmonary Disease) | 925 CLIFTON AVE SUITE 101 CLIFTON, NJ 07013 (973) 778-5070 |
| 1760499099 | DR. JEFFREY C CONFORTI DPM Individual | Podiatrist (Foot & Ankle Surgery) | 925 CLIFTON AVE SUITE 107 CLIFTON, NJ 07013 (973) 472-4700 |
| 1235244609 | MICHAEL F ARDITO M.D. Individual | Internal Medicine | 925 CLIFTON AVE SUITE 200 CLIFTON, NJ 07013 (973) 574-0034 |
| 1861593493 | ROY L BARSOLA PT, DPT Individual | Physical Therapist | 925 CLIFTON AVE SUITE 106 CLIFTON, NJ 07013 (973) 616-7117 |
| 1326279795 | JOHN IVAN SUTTER, MD, PA Organization | Pediatrics | 925 CLIFTON AVE SUITE 102 CLIFTON, NJ 07013 (973) 778-2083 |
| 1891097648 | AHMED MEKKAWY, M.D., P.A. Organization | Clinic/Center (Primary Care) | 925 CLIFTON AVE SUITE 101 CLIFTON, NJ 07013 (973) 778-5070 |
| 1972871366 | PAUL P CUSANO MD PA Organization | Psychiatry & Neurology (Psychiatry) | 925 CLIFTON AVE SUITE 103 CLIFTON, NJ 07013 (973) 471-5256 |
| 1487920377 | GARDEN STATE ORTHOPAEDIC ASSOCIATES, P.A. Organization | Orthopaedic Surgery | 925 CLIFTON AVE SUITE 106 CLIFTON, NJ 07013 (973) 330-0700 |
| 1528347101 | MILLENNIUM HEALTHCARE OF CLIFTON, LLC Organization | Clinic/Center (Ambulatory Surgical) | 925 CLIFTON AVE SUITE #201 CLIFTON, NJ 07013 (973) 249-7700 |
| 1629023478 | STANLEY SZWED M.D. Individual | Internal Medicine (Cardiovascular Disease) | 925 CLIFTON AVE SUITE# 108 CLIFTON, NJ 07013 (973) 471-6200 |
| 1710924048 | DR. PAUL P CUSANO MD Individual | Psychiatry & Neurology (Psychiatry) | 925 CLIFTON AVE SUITE 103 CLIFTON, NJ 07013 (973) 471-5256 |
| 1740639004 | ADVANCED BEHAVIORAL SPECIALISTS, LLC Organization | Community/Behavioral Health | 925 CLIFTON AVE SUITE 103 CLIFTON, NJ 07013 (201) 470-3450 |
| 1942238225 | DR. JOSEPH MEYER ROTH M.D. Individual | Internal Medicine (Gastroenterology) | 925 CLIFTON AVE CLIFTON, NJ 07013 (973) 458-0408 |
| 1801826219 | DR. OLIVER SAMIR YOUSSEF M.D. Individual | Otolaryngology (Otolaryngology/Facial Plastic Surgery) | 925 CLIFTON AVE SUITE 203 CLIFTON, NJ 07013 (973) 773-9250 |
| 1649829276 | MRS. TANIA A WITEK LPC Individual | Counselor (Professional) | 925 CLIFTON AVE CLIFTON, NJ 07013 (973) 943-0907 |
| 1194760694 | STANLEY A SZWED MD Organization | Internal Medicine (Cardiovascular Disease) | 925 CLIFTON AVE SUITE #108 CLIFTON, NJ 07013 (973) 472-6200 |
| 1093800922 | ALLWOOD PHYSICAL THERAPY, LLC Organization | Physical Therapist | 925 CLIFTON AVE SUITE 106 CLIFTON, NJ 07013 (973) 616-7117 |
| 1457404717 | MICHAEL ARDITO, M.D. Organization | Internal Medicine | 925 CLIFTON AVE SUITE 200 CLIFTON, NJ 07013 (973) 574-0034 |
| 1124229588 | CLIFTON FOOT CENTER Organization | Podiatrist (Foot & Ankle Surgery) | 925 CLIFTON AVE STE107 CLIFTON, NJ 07013 (973) 472-4700 |
| 1073631081 | DIANA RICCIOLI M.D. Individual | Psychiatry & Neurology (Psychiatry) | 925 CLIFTON AVE STE 103 CLIFTON, NJ 07013 (973) 417-5256 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417967019, enumerated in the NPI registry as an "individual" on August 08, 2006
The provider is located at 925 Clifton Ave Clifton, Nj 07013 and the phone number is (973) 458-0408
The provider's speciality is Internal Medicine with taxonomy code 207RG0100X with a focus in Gastroenterology
The provider has more than 33 years of experience.
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $144.86 with an average copayment of $36.21 for new patient appointments. Established patients should expect a typical charge of $111.57 and an average copayment of 27.89. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, Biopsy of large bowel using a flexible endoscope, Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month, Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month, Colonoscopy, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Initial hospital inpatient care per day, typically 50 minutes, New patient office or other outpatient visit, 30-44 minutes, Removal of polyps or growths of large bowel using an endoscope with mechanical snare and Upper gastrointestinal (GI) endoscopy for acid reflux.
The practitioner is affiliated to the following hospital(s): ST MARY'S GENERAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on August 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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