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Preferred Provider Access System Application
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Preferred Provider Access System Application

Physician Name:

Tax ID:

NPI:

Email:
Yes No
1.) Do you perform nuclear stress tests in your office?
2.) Does the nuclear lab in your office have ICANL accreditation?
3.) Do you perform outpatient nuclear stress tests in the hospital setting?
4.) Do you perform echo stress tests in your office?
5.) Does the echocardiography lab in your office have ICAEL accreditation?
6.) Do you perform outpatient echo stress tests in the hospital setting?
7.) Do you perform echocardiography in your office?
8.) Do you perform outpatient echocardiography in the hospital setting?
9.) Do you perform diagnostic left heart catheterization (DLHC)?
10.) Does the facility where you perform DLHC report to the ACC-NCDR?


11.) How many cardiology outpatient visits do you see per week?



12.) What percentage of your practice is spent practicing non-invasive cardiology?
13.) What percentage of your practice is spent practicing invasive cardiology?


 
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