DR. ALFRED PROTO M.D.
NPI 1265627384
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Winchester, VA
NPI Status: Active since September 11, 2007
Contact Information
1880 AMHERST STREET
SUITE 310
WINCHESTER, VA
ZIP 22601
Phone: (540) 536-6721
Fax: (540) 536-6724
- Individual
- Male
- Thoracic Surgery (Cardiothoracic Vascula...
- Accepts Insurance
- PECOS Enrolled
About ALFRED PROTO
This page provides the complete NPI Profile along with additional information for Alfred Proto, a provider established in Winchester, Virginia with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery). The healthcare provider is registered in the NPI registry with number 1265627384 assigned on September 2007. The practitioner's primary taxonomy code is 208G00000X with license number 0101284997 (VA). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1265627384
- Provider Name
- DR. ALFRED PROTO M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1880 AMHERST STREET SUITE 310 WINCHESTER, VA 22601
- Location Phone
- (540) 536-6721
- Location Fax
- (540) 536-6724
- Mailing Address
- 220 CAMPUS BLVD STE 320 WINCHESTER, VA 22601
- Mailing Phone
- (540) 536-5100
- Mailing Fax
- (540) 536-6724
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-11-2007
- Last Update Date
- 03-21-2025
- Code Navigator
Location Map
Secondary Locations
- 1840 Amherst St
Winchester, VA 22601
(540) 536-8000
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
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 0101284997
- License State
- VA
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | MT196091 (PA) |
| 2 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2014-01272 (NC) |
| 3 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD449843 (PA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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 Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
- HeartlandBlue Silver $0 Mental Health Visit 6000 NEtwork Blue - EPO
- Bronze Classic - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Secure - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Alfred Proto 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
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
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.
Established patient office or other outpatient visit, 20-29 minutes
This 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 14 times for 11 patientsPhysician Visit Costs
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 22601 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $170.3
- Minimum New Patient Price $56.19
- Maximum New Patient Price $170.3
- Average New Patient Copayment $42.57
- Minimum New Patient Copayment $14.04
- Maximum New Patient Copayment $42.57
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.08
- Minimum Established Patient Price $18.07
- Maximum Established Patient Price $138.91
- Average Established Patient Copayment $17.52
- Minimum Established Patient Copayment $4.51
- Maximum Established Patient Copayment $34.72
* 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.
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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 | 2 | 6 | 5 | 6 | 2 | 7 | 3 | 8 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 12 | 5 | 12 | 2 | 14 | 3 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 2 + 5 + 1 + 2 + 2 + 1 + 4 + 3 + 1 + 6 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1265627384 is valid because the calculated check digit 4 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 |
|---|---|---|---|
| 1003811563 | DR. NEAL S GAITHER MD Individual | Internal Medicine (Interventional Cardiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1043485964 | DR. MANISH J LAKHANI M.D. Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1255394649 | JAMES DIXON BROWN MD Individual | Internal Medicine (Interventional Cardiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1356756795 | IDEAN AMIRJAZIL Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1407212541 | JANICE D ROY NP Individual | Nurse Practitioner | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1528002698 | DR. JAMES EDWARD ANDERSON MD Individual | Internal Medicine (Interventional Cardiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1528021862 | JASON T CALL MD Individual | Internal Medicine (Interventional Cardiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1609839091 | MELANIE DANIELLE MATTSON MD Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1649259102 | KRISTEN L RENZI PA - C Individual | Physician Assistant (Medical) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1679584569 | MICHAEL ALAN EISENFELD PAC Individual | Physician Assistant (Medical) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1801807797 | LISA L BEHNEKE PAC Individual | Physician Assistant (Medical) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1922418185 | DR. DANIEL CHRISTIAN HOBBS M.D. Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1184218174 | SHARON LEE SAVINSKY FNP-BC Individual | Nurse Practitioner (Family) | 1880 AMHERST STREET SUITE 310 WINCHESTER, VA 22601 (540) 536-6721 |
| 1366944670 | VALLEY PHYSICIAN ENTERPRISE, INC. Organization | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET WINCHESTER, VA 22601 (540) 662-0306 |
| 1578229845 | LAUREN ELIZABETH MARTIN PA-C Individual | Physician Assistant (Medical) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1346980026 | MS. KAITLYN ANN BETCHER PA Individual | Physician Assistant (Medical) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1003235227 | DR. RAVEEN CHAWLA M.D. Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1275512550 | RANDOLPH H RENZI MD Individual | Internal Medicine (Interventional Cardiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
| 1114906542 | JEFFREY A SKILES MD Individual | Internal Medicine (Cardiovascular Disease) | 1880 AMHERST STREET SUITE 100 WINCHESTER, VA 22601 (540) 662-0306 |
| 1184841470 | DR. DANIEL V ALEXANDER D.O. Individual | Internal Medicine (Clinical Cardiac Electrophysiology) | 1880 AMHERST STREET SUITE 100 AND SUITE 200 WINCHESTER, VA 22601 (540) 662-0306 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265627384, enumerated in the NPI registry as an "individual" on September 11, 2007
The provider is located at 1880 Amherst Street Suite 310 Winchester, Va 22601 and the phone number is (540) 536-6721
The provider's speciality is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. 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.
Medicare beneficiaries should expect a typical cost of $170.3 with an average copayment of $42.57 for new patient appointments. Established patients should expect a typical charge of $70.08 and an average copayment of 17.52. 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: Established patient office or other outpatient visit, 20-29 minutes.
This NPI record was last updated on September 11, 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].
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