MARTIN F. MCCARTHY MD
NPI 1659330918
Anesthesiology in Miami, FL

Medicare Participation & PECOS Enrollment Status

Martin Mccarthy 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.

Martin Mccarthy 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: 4981877974

  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: I20120118000519

  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.

Anesthesia for exam of colon using an endoscope

Anesthesia for a colon examination with an endoscope is a method used to ensure comfort during the procedure. It involves administering medication to help you relax or sleep, thus reducing discomfort as the endoscope, a thin, flexible tube, is navigated through your colon.

This service was performed 126 times for 126 patients

Anesthesia for injection, drainage or aspiration procedures on spine or spinal cord of lower back accessed through skin using imaging guidance

This procedure involves using anesthesia to numb your lower back for certain procedures like injections, drainage, or aspiration on your spine or spinal cord. Imaging guidance is used to accurately locate the area to be treated, ensuring precision and safety.

This service was performed 115 times for 109 patients

Anesthesia for nerve block and injection

Anesthesia for nerve block and injection is a procedure used to numb specific areas, reducing or blocking pain signals. A medication is injected near nerves to cause numbness in a particular part of your body. This helps in performing certain medical procedures with minimal discomfort.

This service was performed 16 times for 16 patients

Anesthesia for nerve block and injection procedure, prone position

Anesthesia for nerve block and injection is a procedure to numb specific areas, reducing pain. You'll be positioned face-down (prone) for optimal access to the treatment area. The anesthetic is injected near the nerve, blocking pain signals to the brain.

This service was performed 28 times for 27 patients

Anesthesia for nerve destruction procedures on spine or spinal cord of lower back accessed through skin using imaging guidance

This is a procedure where anesthesia is applied to numb specific nerves in your lower back. Using imaging guidance, the doctor can accurately locate these nerves through the skin. This is done to alleviate pain by disrupting nerve signals. It's a safe and effective method.

This service was performed 29 times for 26 patients

Anesthesia for nerve modulation procedure spinal cord or repair of bone of spine of lower back accessed through skin using imaging guidance

Anesthesia for nerve modulation or spine repair involves numbing the lower back area. This is done to ensure you don't feel pain during the procedure. The doctor uses imaging technology to accurately place the anesthetic. This makes the procedure safer and more effective.

This service was performed 45 times for 44 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

This service was performed 196 times for 189 patients

Anesthesia for other procedure on large bowel using an endoscope

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

This service was performed 89 times for 89 patients

Anesthesia for other procedure on lower abdomen

Anesthesia for a lower abdomen procedure involves medication to eliminate pain during surgery. You might be awake but relaxed and pain-free, or you may be completely unconscious. It's administered to ensure comfort and safety throughout the operation.

This service was performed 15 times for 15 patients

Anesthesia for other procedure on lower spine

Anesthesia for a lower spine procedure involves administering medication to block pain and sensation in your back. This ensures comfort and stillness during the procedure. The type of anesthesia used depends on the specific procedure and your overall health.

This service was performed 35 times for 35 patients

Anesthesia for other procedure on skin of arms, legs, and front body

Anesthesia for procedures on the skin of your arms, legs, and front body is a service that numbs the area being treated. This ensures you don't feel pain during procedures like biopsies, stitches, or minor surgeries. It's administered through a small injection or a topical cream.

This service was performed 16 times for 16 patients

Anesthesia for procedure for total knee joint replacement

Anesthesia for a total knee joint replacement numbs your body to eliminate pain during surgery. This could be general anesthesia where you're unconscious, or regional anesthesia where only the leg is numb. It's administered by a specialist, ensuring safety and comfort.

This service was performed 38 times for 38 patients

Anesthesia for procedure on nerves, muscles, tendons, and tissue of forearm, wrist, and hand

Anesthesia for procedures on the forearm, wrist, and hand involves administering medication to block sensation in these areas. This helps ensure comfort and painlessness during surgeries or treatments involving nerves, muscles, tendons, and tissue in these regions.

This service was performed 19 times for 19 patients

Anesthesia for procedure on small and large bowel using an endoscope

Anesthesia for an endoscopic procedure on the small and large bowel ensures comfort and relaxation during the procedure. It involves administering medicine to help you sleep or feel drowsy. This allows the doctor to examine your bowels without causing you discomfort or pain.

This service was performed 23 times for 23 patients

Anesthesia for procedure to correct abnormal heart rhythm

Anesthesia for a procedure to correct abnormal heart rhythm ensures you won't feel pain during the treatment. It can be general, where you're completely asleep, or local, numbing only a specific area. Your vital signs are monitored to ensure safety during the procedure.

This service was performed 22 times for 20 patients

Anesthesia for x-ray or radiation therapy

Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.

This service was performed 20 times for 20 patients

Injection of anesthetic agent and/or steroid into arm nerve bundle

This procedure involves injecting a numbing agent or steroid into your arm's nerve bundle. It's done to manage pain or inflammation. The injection helps block nerve signals that cause discomfort, providing relief. It's a safe, common procedure.

This service was performed 17 times for 16 patients

Injection of anesthetic agent and/or steroid into thigh nerve

This procedure involves injecting a numbing agent and/or steroid into a nerve in your thigh. It's done to alleviate pain or inflammation. A needle will be carefully positioned near the nerve, and the medicine will be administered.

This service was performed 37 times for 37 patients

Ultrasonic guidance for needle placement

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

This service was performed 40 times for 39 patients

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 63.04, 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: 63.04 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: 56.51

  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: N/A

  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: N/A

  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: N/A

  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.

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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 1659330918 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