PROF. JOHANNA PAOLA CONTRERAS M.D, MSC
NPI 1528188190
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in New York, NY

Medicare Participation & PECOS Enrollment Status

Johanna Contreras 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.

Johanna Contreras 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: 4587711866

  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: I20111121000200

  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 (DE017N)

  Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) (HCPCS:A4221)

  2 DME suppliers used 15 Medicare Claims 15 Services Paid

• DME-Medical/Surgical Supplies (DA000N)

  Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) (HCPCS:A4222)

  2 DME suppliers used 15 Medicare Claims 98 Services Paid

Unknown

• Treatment-Injections and Infusions (nononcologic) (RI026N)

  Injection, milrinone lactate, 5 mg (HCPCS:J2260)

  2 DME suppliers used 18 Medicare Claims 598 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Azathioprine, oral, 50 mg (HCPCS:J7500)

  1 DME suppliers used 12 Medicare Claims 360 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Cyclosporine, oral, 100 mg (HCPCS:J7502)

  2 DME suppliers used 41 Medicare Claims 2460 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Tacrolimus, immediate release, oral, 1 mg (HCPCS:J7507)

  3 DME suppliers used 18 Medicare Claims 2220 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Prednisone, immediate release or delayed release, oral, 1 mg (HCPCS:J7512)

  2 DME suppliers used 17 Medicare Claims 1725 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Cyclosporine, oral, 25 mg (HCPCS:J7515)

  2 DME suppliers used 27 Medicare Claims 2430 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Mycophenolate mofetil, oral, 250 mg (HCPCS:J7517)

  3 DME suppliers used 17 Medicare Claims 3840 Services Paid

• Treatment-Treatment - Miscellaneous (RX029N)

  Everolimus, oral, 0.25 mg (HCPCS:J7527)

  2 DME suppliers used 13 Medicare Claims 1260 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)

  6 DME suppliers used 63 Medicare Claims 63 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)

  5 DME suppliers used 92 Medicare Claims 96 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.

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 96 times for 34 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 51 times for 37 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 94 times for 60 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 18 times for 12 patients

Evaluation of lower heart chamber assist device

An evaluation of a lower heart chamber assist device is a procedure to check the function of an implanted device aiding your heart's lower chambers. This helps ensure optimal heart function by monitoring the device's performance and your heart's response to it.

This service was performed 32 times for 14 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 138 times for 55 patients

Remote monitoring of pulmonary artery pressure sensor, up to 30 days

Remote monitoring of pulmonary artery pressure is a procedure where a sensor, placed in your lung artery, transmits data about your heart's function for up to 30 days. This helps doctors monitor your heart health remotely, ensuring timely intervention if needed.

This service was performed 36 times for 25 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 68 times for 49 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 23 times for 14 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $37.56 for a new patient copayment and $28.72 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 10029 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. Johanna Contreras 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 1528188190 is valid because the calculated check digit 0 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