Active NPI 1134533912 Individual Practitioner Male Practitioner

Dr. Nicholas D Sousa , DO

Surgery • Madison Heights, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Nicholas Sousa, DO is a certified Surgery practicing in Madison Heights, MI. With approximately 12 years of clinical experience since graduating from Lake Erie College Of Osteopathic Medicine, Erie in 2014, Dr. Sousa delivers high-quality medical care to the local community at 27483 DEQUINDRE RD STE 301.

Dr. Sousa maintains professional affiliations with Henry Ford Health Macomb Oakland Hospital, Michigan Healthcare Professionals Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, initial hospital care with straightforward or low-level medical decision making, if using time, at least, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

27483 Dequindre Rd Ste 301

Madison Heights, MI 480715715

Telephone 2485462600

Associated Practice Facility / Clinic

🏢 Oakland Macomb Surgical Group Pllc Facility NPI 1124208335

Medicare Profile & Education

Medical School

Lake Erie College Of Osteopathic Medicine, Erie

Graduation Year

2014

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Madison Heights, MI

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

12 Yrs -4.1 yrs vs City Avg

City Avg: 16.1 Yrs

State Avg: 25.8 Yrs

Regional Practice Density

9 Specialists

Practicing in Madison Heights, MI (1479 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sousa (12 Years) 12 Yrs

Madison Heights Specialty Average (16.1 Years) 16.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	260	147	$109.85	$78.60
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	151	145	$175.42	$130.44
99213 Established patient office or other outpatient visit, typically 15 minutes	58	31	$143.24	$91.86
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	17	15	$481.76	$132.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	13	$201.63	$129.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$264.33	$170.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	232	113	$100.00	$79.86
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	129	123	$196.62	$133.32
99213 Established patient office or other outpatient visit, typically 15 minutes	58	40	$158.21	$91.34
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$176.00	$110.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	253	118	$100.00	$71.31
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	108	96	$196.52	$137.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	45	32	$218.40	$129.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$177.38	$114.06
99213 Established patient office or other outpatient visit, typically 15 minutes	37	31	$149.24	$90.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$280.08	$174.18
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	17	17	$349.94	$141.18
47562 Removal of gallbladder using an endoscope	15	15	$1220.00	$739.35
43246 Insertion of stomach tube using a flexible endoscope	12	11	$376.00	$196.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	204	89	$60.00	$39.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	84	37	$100.00	$73.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	41	$202.14	$131.03
99221 Initial hospital inpatient care per day, typically 30 minutes	51	49	$131.00	$103.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$271.73	$169.69
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	38	36	$177.00	$140.53
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	27	27	$425.44	$143.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	68	27	$60.00	$41.41
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	27	20	$177.00	$74.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$276.71	$171.81
99221 Initial hospital inpatient care per day, typically 30 minutes	13	13	$181.46	$108.25
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$332.00	$191.52

Medical Specialties & State Licenses

CMS Verified: 2020-10-14

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License MI 5101021243

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Hospital & Practice Group Affiliations

Michigan Healthcare Professionals Pc

27483 Dequindre Rd, Madison Heights, MI 480715715

Phone: 2485462600

Henry Ford Health Macomb Oakland Hospital

27483 Dequindre Rd, Madison Heights, MI 480715711

Phone: 2489677326

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners

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Surgery

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