ANNE MARIE PRABULOS MD
NPI 1235136680
Obstetrics & Gynecology - Maternal & Fetal Medicine in Farmington, CT


Quality Rating: 77.12 out of 100 score

NPI Status: Active since June 30, 2005

Contact Information

263 FARMINGTON AVE
FARMINGTON, CT
ZIP 06030
Phone: (860) 679-3387
Fax: (860) 679-1271

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  • Individual
  • Female
  • Years of Experience 35
  • Obstetrics & Gynecology
  • Maternal & Fetal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ANNE MARIE PRABULOS

This page provides the complete NPI Profile along with additional information for Anne Marie Prabulos, a women's health care provider established in Farmington, Connecticut with a medical specialization in Obstetrics & Gynecology, focusing in maternal & fetal medicine and more than 35 years of experience. She graduated from University Of Connecticut School Of Medicine in 1991. The healthcare provider is registered in the NPI registry with number 1235136680 assigned on June 2005. The practitioner's primary taxonomy code is 207VM0101X with license number 034574 (CT). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1235136680
Provider Name
ANNE MARIE PRABULOS MD
Gender
Female
Entity Type
Individual
Location Address
263 FARMINGTON AVE FARMINGTON, CT 06030
Location Phone
(860) 679-3387
Location Fax
(860) 679-1271
Mailing Address
263 FARMINGTON AVE PROVIDER ENROLLMENT FARMINGTON, CT 06030
Mailing Phone
(860) 679-7503
Mailing Fax
(860) 679-1271
Medical School Name
UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduation Year
1991
Is Sole Proprietor?
No
Enumeration Date
06-30-2005
Last Update Date
09-12-2022
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Women's health care providers like Anne Marie Prabulos treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

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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

Obstetrics & Gynecology Maternal & Fetal Medicine

Taxonomy Code
207VM0101X
Type
Allopathic & Osteopathic Physicians
License No.
034574
License State
CT
Taxonomy Description
An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1345744MEDICAID (05)CT 

Medicare Participation & PECOS Enrollment Status

Anne Marie Prabulos 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.

Anne Marie Prabulos 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: 2769517150

    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: I20100324000701

    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

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $34.71 for a new patient copayment and $18.88 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 06030 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $138.84
  • Minimum New Patient Price $60.82
  • Maximum New Patient Price $183.1
  • Average New Patient Copayment $34.71
  • Minimum New Patient Copayment $15.2
  • Maximum New Patient Copayment $45.77

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.55
  • Minimum Established Patient Price $19.76
  • Maximum Established Patient Price $149.26
  • Average Established Patient Copayment $18.88
  • Minimum Established Patient Copayment $4.94
  • Maximum Established Patient Copayment $37.31

* 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 77.12, 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.

  • Final Score: 77.12 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.

  • Quality Score: 68.1

    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.

  • 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: 41.83

    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: 41.83

    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.

Reviews for ANNE MARIE PRABULOS MD

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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.
1235136680
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22652312616
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 6 + 5 + 2 + 3 + 1 + 2 + 6 + 1 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1235136680 is valid because the calculated check digit 0 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
1609879519 MICHAEL JOSEPH GIORDANO MD
Individual
Neurological Surgery263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4228
1689679375 DALAL CHENOUDA
Individual
Internal Medicine263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4477
1255336970 MARGARET GRUNNET M.D.
Individual
Pathology (Anatomic Pathology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2980
1164427886 NICHOLAS DEMARTINIS
Individual
Psychiatry & Neurology (Psychiatry)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-6700
1184629875 JAMES W FRESTON M.D.
Individual
Internal Medicine (Gastroenterology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-3238
1124023957 SHIRLEY ALLEN RD
Individual
Dietitian, Registered263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4477
1831194661 DOUGLAS V ALMOND M.D.
Individual
Internal Medicine263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4477
1538164397 PATTILYNN CONARD
Individual
Nurse Anesthetist, Certified Registered263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-3516
1982600300 MORVEN C BARWICK MD
Individual
Psychiatry & Neurology (Neurology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-3186
1124024559 ROBERT D BONA MD
Individual
Internal Medicine (Hematology & Oncology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2100
1346246543 DIANE HOSS
Individual
Dermatology263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4600
1952307159 ANNA HENISZ MD
Individual
Radiology (Diagnostic Radiology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2784
1881690881 JANET E MCELHANEY MD
Individual
Family Medicine (Geriatric Medicine)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-8400
1952307977 JAMES O MENZOIAN MD
Individual
Surgery (Vascular Surgery)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-3540
1659377653 GEORGE A MANSOOR MD
Individual
Internal Medicine263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-3343
1215933841 VICTOR MOYO MD
Individual
Internal Medicine (Hematology & Oncology)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2100
1750388302 MARY LYNN NEWPORT MD
Individual
Orthopaedic Surgery263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-6600
1942207501 KLAUS NUKI BDS
Individual
Dentist263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2952
1942207386 EDWARD L PESANTI MD
Individual
Internal Medicine (Infectious Disease)263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-4225
1164429502 ANDREW E POOLE BDS
Individual
Dentist263 FARMINGTON AVE
FARMINGTON, CT 06030
(860) 679-2952

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235136680, enumerated in the NPI registry as an "individual" on June 30, 2005

The provider is located at 263 Farmington Ave Farmington, Ct 06030 and the phone number is (860) 679-3387

The provider's speciality is Obstetrics & Gynecology with taxonomy code 207VM0101X with a focus in Maternal & Fetal Medicine

The provider has more than 35 years of experience. She graduated from University Of Connecticut School Of Medicine in 1991.

The provider might be accepting Accepts: Medicare and Medicaid. 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 $138.84 with an average copayment of $34.71 for new patient appointments. Established patients should expect a typical charge of $75.55 and an average copayment of 18.88. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on June 30, 2005. 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].
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