| National Provider Identifier [NPI]: | 1568660090 |
| Last Name Of The Provider | GHANAVATI |
| First Name Of The Provider | HABIBOLLAH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 661 E ALTAMONTE DR |
| Street Address 2 Of The Provider | SUITE 316 |
| City Of The Provider | ALTAMONTE SPRINGS |
| Zip Code Of The Provider | 327015105 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 1894 |
| Number Of Medicare Beneficiaries | 638 |
| Total Submitted Charge Amount | 2568050 |
| Total Medicare Allowed Amount | 267157.72 |
| Total Medicare Payment Amount | 209404.92 |
| Total Medicare Standardized Payment Amount | 199577.55 |
| 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 | 8 |
| Number Of Medical Services | 1894 |
| Number Of Medicare Beneficiaries With Medical Services | 638 |
| Total Medical Submitted Charge Amount | 2568050 |
| Total Medical Medicare Allowed Amount | 267157.72 |
| Total Medical Medicare Payment Amount | 209404.92 |
| Total Medical Medicare Standardized Payment Amount | 199577.55 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 367 |
| Number Of Male Beneficiaries | 271 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 49 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 52 |
| Average HCC Risk Score Of Beneficiaries | 2.1788 |