HEATHER L ELIAS M.D.
NPI 1023208162
Internal Medicine - Endocrinology, Diabetes & Metabolism in Worcester, MA
Quality Rating: 90.7 out of 100 score
NPI Status: Active since July 25, 2007
- NPI Profile Information
- Primary Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 22
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About HEATHER ELIAS
This page provides the complete NPI Profile along with additional information for Heather Elias, an internist established in Worcester, Massachusetts with a medical specialization in Internal Medicine, focusing in endocrinology, diabetes & metabolism and more than 22 years of experience. She graduated from University Of Vermont College Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1023208162 assigned on July 2007. The practitioner's primary taxonomy code is 207RE0101X with license number 232287 (MA). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1023208162
- Provider Name
- HEATHER L ELIAS M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 55 LAKE AVE N WORCESTER, MA 01655
- Location Phone
- (508) 334-3239
- Mailing Address
- LAHEY HOSPITAL AND MEDICAL CENTER 41 MALL ROAD BURLINGTON, MA 01805
- Mailing Phone
- (781) 744-8000
- Medical School Name
- UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
- Graduation Year
- 2004
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-25-2007
- Last Update Date
- 08-23-2019
- Code Navigator
An internist like Heather Elias is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 232287
- License State
- MA
- Taxonomy Description
- An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Heather Elias 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.
Heather Elias 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: 8527150325
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: I20070824000379
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
34 DME suppliers used 85 Medicare Claims 259 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
13 DME suppliers used 18 Medicare Claims 30 Services Paid
DME-Other DME (DE017N)
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)
13 DME suppliers used 184 Medicare Claims 186 Services Paid
DME-Other DME (DE017N)
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system (HCPCS:K0554)
10 DME suppliers used 15 Medicare Claims 15 Services Paid
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.
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Initial hospital inpatient care per day, typically 30 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
Telephone medical discussion with physician, 11-20 minutes
Telephone medical discussion with physician, 21-30 minutes
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
This service was performed 33 times for 18 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 21 times for 17 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 234 times for 155 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 39 times for 34 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 124 times for 52 patientsInitial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
This service was performed 19 times for 18 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 11 times for 11 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 70 times for 70 patientsThis is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
This service was performed 14 times for 14 patientsThis service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
This service was performed 25 times for 22 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $33.61 for a new patient copayment and $25.87 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 01655 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.47
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.61
- Minimum New Patient Copayment $14.71
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.48
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $25.87
- Minimum Established Patient Copayment $4.77
- Maximum Established Patient Copayment $36.21
* 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.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.7, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 90.7 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 76.53
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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. Heather Elias is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTHEAST HOSPITAL CORPORATION | 85 HERRICK STREET BEVERLY, MA 01915 | (978) 922-3000 | Acute Care Hospitals | |
| BETH ISRAEL DEACONESS MEDICAL CENTER | 330 BROOKLINE AVENUE BOSTON, MA 02215 | (617) 667-7000 | Acute Care Hospitals | |
| NEWTON-WELLESLEY HOSPITAL | 2014 WASHINGTON STREET NEWTON, MA 02462 | (617) 243-6000 | Acute Care Hospitals | |
| WINCHESTER HOSPITAL | 41 HIGHLAND AVENUE WINCHESTER, MA 01890 | (781) 729-9000 | Acute Care Hospitals | |
| LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON | 41 & 45 MALL ROAD BURLINGTON, MA 01803 | (781) 744-5100 | Acute Care Hospitals |
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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.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 2 | 3 | 2 | 0 | 8 | 1 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 4 | 3 | 4 | 0 | 16 | 1 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 4 + 3 + 4 + 0 + 1 + 6 + 1 + 1 + 2 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1023208162 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1457352775 | DR. SARAH BETH SAXER PHARMD Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N UMASS MED CENTER DEPT OF PHARMACY WORCESTER, MA 01655 (508) 856-2763 |
| 1891797361 | MARTHA LAROSE SAMPSON CRNA Individual | Nurse Anesthetist, Certified Registered | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1902899370 | LINDA A PAPE M.D. Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N CARDIOLOGY WORCESTER, MA 01655 (508) 856-3050 |
| 1124013271 | DR. DALE E RAUCH M.D. Individual | Psychiatry & Neurology (Psychiatry) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-6580 |
| 1225025562 | DR. MAICHI T TRAN PHARM.D. Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-1618 |
| 1427045509 | DR. JENNIFER L DONOVAN PHARM.D. Individual | Pharmacist | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-4101 |
| 1215925516 | JESSICA L DOUGLAS MS Individual | Genetic Counselor, MS | 55 LAKE AVE N S1-710 WORCESTER, MA 01655 (508) 334-3517 |
| 1295723310 | DR. JULIANNE PATRICIA HUBER MD Individual | Emergency Medicine | 55 LAKE AVE N WORCESTER, MA 01655 (508) 421-1400 |
| 1013906999 | DR. CHRISTIAN HARTMAN PHARMD Individual | 55 LAKE AVE N PHARMACY DEPARTMENT WORCESTER, MA 01655 (508) 334-7832 | |
| 1609866607 | ELLEN M GRAVALLESE M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 334-5224 |
| 1497745806 | DR. ABIGAIL ADAMS M.D. Individual | Internal Medicine | 55 LAKE AVE N DEPARTMENT OF GENERAL MEDICINE WORCESTER, MA 01655 (508) 856-2731 |
| 1710977046 | GAMZE AYATA MD Individual | Pathology (Anatomic Pathology) | 55 LAKE AVE N DEPARTMENT OF PATHOLOGY WORCESTER, MA 01655 (508) 793-6100 |
| 1821088139 | DR. MARIANNE E FELICE M.D. Individual | Pediatrics (Adolescent Medicine) | 55 LAKE AVE N DEPARTMENT OF PEDIATRIC ADOLESCENT MEDICINE WORCESTER, MA 01655 (508) 856-3199 |
| 1437140308 | JOHN PULLERITS M.D. Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1558352492 | DIANA I. KOUZNETSOV MD Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1174514764 | OSCAR EPHRAM STAROBIN MD Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-3603 |
| 1942291570 | DR. STANLEY K TAM MD Individual | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 55 LAKE AVE N DEPARTMENT OF SURGERY WORCESTER, MA 01655 (508) 334-3962 |
| 1558352922 | MICHAEL C. BUTLER MD Individual | Emergency Medicine | 55 LAKE AVE N DEPARTMENT OF EMERGENCY MEDICINE WORCESTER, MA 01655 (508) 421-1400 |
| 1841281078 | DR. RUBEN PERALTA M.D. Individual | Surgery (Surgical Critical Care) | 55 LAKE AVE N DEPARTMENT OF SURGICAL CRITICAL CARE WORCESTER, MA 01655 (508) 856-5288 |
| 1598746653 | ROBERT B ZURIER M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N DEPARTMENT OF RHEUMATOLOGY WORCESTER, MA 01655 (508) 856-6246 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023208162, enumerated in the NPI registry as an "individual" on July 25, 2007
The provider is located at 55 Lake Ave N Worcester, Ma 01655 and the phone number is (508) 334-3239
The provider's speciality is Internal Medicine with taxonomy code 207RE0101X with a focus in Endocrinology, Diabetes & Metabolism
The provider has more than 22 years of experience. She graduated from University Of Vermont College Of Medicine in 2004.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld and Anthem Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $134.47 with an average copayment of $33.61 for new patient appointments. Established patients should expect a typical charge of $103.48 and an average copayment of 25.87. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Initial hospital inpatient care per day, typically 30 minutes, Initial hospital inpatient care per day, typically 70 minutes, New patient office or other outpatient visit, 45-59 minutes, Telephone medical discussion with physician, 11-20 minutes and Telephone medical discussion with physician, 21-30 minutes.
The practitioner is affiliated to the following hospital(s): NORTHEAST HOSPITAL CORPORATION, BETH ISRAEL DEACONESS MEDICAL CENTER, NEWTON-WELLESLEY HOSPITAL, WINCHESTER HOSPITAL and LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on July 25, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.