DR. SUSAN J MAYGARDEN MD
NPI 1811080500
Pathology - Clinical Pathology/Laboratory Medicine in Chapel Hill, NC

Medicare Participation & PECOS Enrollment Status

Susan Maygarden 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.

Susan Maygarden 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: 9335276641

  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: I20100419000373

  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.

Pathology examination of specimen during surgery, each additional tissue block

During surgery, a pathology examination may be done on additional tissue blocks. This involves taking small samples of tissue and examining them under a microscope. This helps identify any abnormal cells or diseases present, aiding in the precise diagnosis and treatment planning.

This service was performed 46 times for 15 patients

Pathology examination of specimen during surgery, first tissue block

A pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.

This service was performed 132 times for 37 patients

Pathology examination of tissue using a microscope, high complexity

A high complexity pathology examination involves studying body tissue under a microscope to identify any abnormalities. This intricate process helps in diagnosing various conditions and deciding on the best treatment plan.

This service was performed 35 times for 31 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 383 times for 167 patients

Pathology examination of tissue using a microscope, limited examination

A pathology examination of tissue using a microscope is a procedure where a small sample of your tissue is observed under a microscope. This limited examination helps identify any abnormal cells or signs of disease, aiding in accurate diagnosis and treatment planning.

This service was performed 11 times for 11 patients

Pathology examination of tissue using a microscope, moderately high complexity

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

This service was performed 145 times for 83 patients

Pathology examination of tissue using a microscope, moderately low complexity

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

This service was performed 26 times for 20 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 80 times for 51 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 120 times for 40 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 59 times for 50 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 23 times for 16 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 35 times for 34 patients

Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method

This procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.

This service was performed 22 times for 22 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.25 for a new patient copayment and $23.98 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 27599 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. Susan Maygarden 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 1811080500 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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Frequently Asked Questions