| National Provider Identifier [NPI]: | 1104848811 |
| Last Name Of The Provider | GLADSTEIN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 HAWKINS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE RONKONKOMA |
| Zip Code Of The Provider | 117792324 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 39247 |
| Number Of Medicare Beneficiaries | 1485 |
| Total Submitted Charge Amount | 1930210.88 |
| Total Medicare Allowed Amount | 816200.58 |
| Total Medicare Payment Amount | 636399.57 |
| Total Medicare Standardized Payment Amount | 585558.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 39247 |
| Number Of Medicare Beneficiaries With Medical Services | 1485 |
| Total Medical Submitted Charge Amount | 1930210.88 |
| Total Medical Medicare Allowed Amount | 816200.58 |
| Total Medical Medicare Payment Amount | 636399.57 |
| Total Medical Medicare Standardized Payment Amount | 585558.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 509 |
| Number Of Beneficiaries Age 65 to 74 | 513 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 689 |
| Number Of Male Beneficiaries | 796 |
| Number Of Non Hispanic White Beneficiaries | 868 |
| Number Of Black or African American Beneficiaries | 380 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 163 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1344 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 64 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 60 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2433 |