JUSTIN B. DALTON MD
NPI 1639339328
Pathology - Anatomic Pathology & Clinical Pathology in Richmond, VA

Medicare Participation & PECOS Enrollment Status

Justin Dalton 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.

Justin Dalton 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: 4385877125

  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: I20140502000404

  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.

Blood bank physician services for cross match and/or evaluation and written report

Blood bank physician services for cross match involve testing your blood against donor blood to ensure compatibility before a transfusion. The evaluation includes a detailed analysis of your blood type and antibodies. A written report will be provided, summarizing the findings.

This service was performed 15 times for 15 patients

Blood smear interpretation by physician with written report

Blood smear interpretation is a lab test where your doctor examines a sample of your blood under a microscope. They look for abnormalities in your blood cells which can help diagnose various conditions. You'll receive a written report of the findings.

This service was performed 45 times for 42 patients

Bone marrow, smear interpretation

Bone marrow smear interpretation is a procedure where a small sample of your bone marrow is taken and examined under a microscope. This helps doctors identify any abnormal cells or signs of diseases such as anemia, leukemia, or infections. It's a crucial step in diagnosing various blood disorders.

This service was performed 40 times for 39 patients

Bone marrow, smear interpretation

Bone marrow smear interpretation is a procedure where a small sample of your bone marrow is taken and examined under a microscope. This helps doctors identify any abnormal cells or signs of diseases such as anemia, leukemia, or infections. It's a crucial step in diagnosing various blood disorders.

This service was performed 17 times for 17 patients

Immunologic analysis technique on body fluid, other fluids with concentration

Immunologic analysis is a diagnostic method that assesses your body fluids to detect health issues. It involves concentrating these fluids to enhance detection of specific proteins or cells. It helps identify immune system responses, aiding in accurate diagnosis and treatment.

This service was performed 88 times for 72 patients

Immunologic analysis technique on serum (immunofixation)

Immunofixation is a lab test that helps identify proteins called immunoglobulins in your blood serum. These proteins are part of your immune system. Changes in their levels can indicate certain diseases. The test is simple and only requires a blood sample.

This service was performed 13 times for 13 patients

Immunologic analysis technique on serum (immunofixation)

Immunofixation is a lab test that helps identify proteins called immunoglobulins in your blood serum. These proteins are part of your immune system. Changes in their levels can indicate certain diseases. The test is simple and only requires a blood sample.

This service was performed 266 times for 201 patients

Mechanical separation of plasma from blood

Mechanical separation of plasma from blood is a procedure where your blood is drawn and placed in a machine. This machine spins the blood at high speeds, separating the plasma (a yellowish fluid) from the rest of the blood components. The plasma is then collected for medical purposes.

This service was performed 22 times for 15 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 68 times for 29 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 30 times for 15 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 43 times for 40 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 22 times for 22 patients

Preparation of tissue for examination by removing any calcium present

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

This service was performed 34 times for 34 patients

Preparation of tissue for examination by removing any calcium present

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

This service was performed 18 times for 18 patients

Protein measurement, body fluid

A protein measurement of body fluid is a test that gauges the amount of proteins in your fluids. This analysis helps in detecting various health conditions. It's done via a simple sample collection process, usually from blood or urine, in a safe and painless manner.

This service was performed 18 times for 17 patients

Protein measurement, body fluid

A protein measurement of body fluid is a test that gauges the amount of proteins in your fluids. This analysis helps in detecting various health conditions. It's done via a simple sample collection process, usually from blood or urine, in a safe and painless manner.

This service was performed 92 times for 77 patients

Protein measurement, serum

A serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.

This service was performed 25 times for 25 patients

Protein measurement, serum

A serum protein measurement is a blood test that determines the levels of proteins in your blood. It is used to evaluate your overall health, and diagnose nutritional problems, kidney disease, liver disease, or immune disorders.

This service was performed 375 times for 250 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 49 times for 38 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 28 times for 23 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 50 times for 13 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 30 times for 25 patients

Surgical pathology consultation and report on referred slides prepared elsewhere

A surgical pathology consultation involves reviewing slides prepared at a different lab to confirm or clarify a diagnosis. It's a second opinion to ensure accuracy. A report with findings and interpretations is then provided for your doctor's reference.

This service was performed 17 times for 16 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.26 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 23298 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. Justin Dalton 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 1639339328 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

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Frequently Asked Questions