HENRY C. MARQUEZ M.D.
NPI 1700803756
Internal Medicine - Cardiovascular Disease in Sedalia, MO

Medicare Participation & PECOS Enrollment Status

Henry Marquez 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.

Henry Marquez 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: 4385733880

  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: I20071207000201

  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

• Other-Enteral and Parenteral (OB006N)

  Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape (HCPCS:B4034)

  1 DME suppliers used 11 Medicare Claims 292 Services Paid

• Other-Enteral and Parenteral (OB006N)

  Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit (HCPCS:B4152)

  1 DME suppliers used 11 Medicare Claims 5115 Services Paid

Durable Medical Equipment

• DME-Oxygen and Supplies (DC002N)

  Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

  1 DME suppliers used 18 Medicare Claims 18 Services Paid

• DME-Oxygen and Supplies (DC000N)

  Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:K0738)

  1 DME suppliers used 12 Medicare Claims 12 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.

Anticoagulant management of patient taking warfarin

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

This service was performed 1,293 times for 95 patients

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring

An Electrocardiogram (ECG) is a test that monitors your heart's electrical activity for up to 30 days. It helps identify irregular heartbeats or rhythms. You'll wear a small device that records your heart activity, especially when symptoms like chest pain or palpitations occur.

This service was performed 60 times for 60 patients

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional

An Electrocardiogram (ECG) is a test that records the electrical activity of your heart. For up to 30 days, a device will continuously monitor your heart's rhythm, noting any symptoms. The data is sent to a healthcare professional who reviews it and provides a report on your heart health.

This service was performed 62 times for 62 patients

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring, transmission and review and report by health care professional

An Electrocardiogram (ECG) is a test that records the electrical activity of your heart. For up to 30 days, a device will continuously monitor your heart's rhythm, noting any symptoms. The data is sent to a healthcare professional who reviews it and provides a report on your heart health.

This service was performed 60 times for 60 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 41 times for 32 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 196 times for 190 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 38 times for 30 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 804 times for 705 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 19 times for 19 patients

Evaluation of cardiac rhythm monitor system, remote up to 30 days

This procedure involves remotely monitoring your heart rhythm for up to 30 days. A small device will record your heart's activity, which can be accessed by your healthcare team. This aids in diagnosing any irregularities or issues with your heart function.

This service was performed 340 times for 53 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

This service was performed 18 times for 18 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.

This service was performed 607 times for 220 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days

This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.

This service was performed 469 times for 168 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.

This service was performed 144 times for 54 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

This service was performed 253 times for 245 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

This service was performed 253 times for 245 patients

External shock to heart to regulate heart beat

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

This service was performed 49 times for 41 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 114 times for 57 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 496 times for 151 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 88 times for 44 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 141 times for 125 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 48 times for 43 patients

Insertion of heart rhythm monitor under skin

The insertion of a heart rhythm monitor under the skin is a procedure to track your heart's activity. A small device is placed under your skin, recording your heart's rhythms continuously. This helps identify irregular heartbeats or conditions, aiding in your treatment.

This service was performed 14 times for 13 patients

Insertion of pacemaker and upper and lower heart chamber electrode

A pacemaker insertion is a procedure where a small device, called a pacemaker, is implanted under your skin. This device uses electrical pulses to prompt the heart to beat at a normal rate. Electrodes are placed in the upper and lower chambers of your heart to help regulate your heartbeat.

This service was performed 17 times for 17 patients

Insertion of tube in coronary artery for diagnosis with review by radiologist

This procedure involves placing a small tube into your coronary artery. It helps to identify any blockages or issues within the artery. A radiologist, a doctor specialized in medical imaging, will review the results to ensure accurate diagnosis.

This service was performed 11 times for 11 patients

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist

This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.

This service was performed 41 times for 41 patients

Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec

This procedure involves the remote monitoring of an implanted device in your heart for up to 30 days. The device collects data about your heart's function which is transmitted and analyzed. The goal is to track your heart's rhythm and identify any abnormalities.

This service was performed 339 times for 53 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 11 times for 11 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 26 times for 26 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 52 times for 52 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 163 times for 99 patients

Pacemaker insertion or repair

Pacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.

This service was performed for 12 patients

Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent

This service involves your doctor evaluating your home INR (a blood clotting test) results. It's for patients with a mechanical heart valve, chronic atrial fibrillation, or venous thromboembolism who meet specific criteria. It helps manage your treatment, but tests aren't conducted frequently.

This service was performed 78 times for 12 patients

Programming of dual lead implantable defibrillator system

Programming of a dual lead implantable defibrillator system involves adjusting settings on a device implanted in your chest. This device monitors your heart rhythm and delivers electrical pulses to correct irregular heartbeats, helping maintain a healthy heart rhythm.

This service was performed 21 times for 18 patients

Programming of dual lead pacemaker system

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

This service was performed 151 times for 133 patients

Programming of multiple lead implantable defibrillator system

Programming of a multiple lead implantable defibrillator system involves adjusting settings on your implanted device to help control irregular heart rhythms. The process is non-invasive and helps ensure optimal device performance for maintaining heart health.

This service was performed 42 times for 34 patients

Programming of multiple lead pacemaker system

Programming of a multiple lead pacemaker system involves adjusting settings on your pacemaker device to optimize its function. This device uses electrical impulses to regulate your heart's rhythm. The procedure ensures it's working effectively for your specific needs.

This service was performed 13 times for 11 patients

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

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 905 times for 810 patients

Ultrasound of both sides of head and neck blood flow

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

This service was performed 79 times for 78 patients

Ultrasound of heart blood flow, valves and chambers, follow-up

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

This service was performed 19 times for 19 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

This service was performed 34 times for 32 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 334 times for 328 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 147 times for 145 patients

Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report

This procedure involves using ultrasound technology to create images of your heart while you rest, exercise, or undergo drug-induced stress. An ECG continuously monitors your heart's electrical activity. It helps doctors assess heart health and function.

This service was performed 12 times for 12 patients

Ultrasound of heart with probe in esophagus, with report

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

This service was performed 34 times for 32 patients

Ultrasound of heart, follow-up

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

This service was performed 63 times for 56 patients

Ultrasound of heart, follow-up

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

This service was performed 43 times for 39 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

This service was performed 151 times for 132 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.49 for a new patient copayment and $16.42 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 65301 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.

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.

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. Henry Marquez 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 1700803756 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 7 providers are registered at the same or nearby location.

Frequently Asked Questions