DR. THEODORA PAPPA MD, PHD
NPI 1285154674
Internal Medicine in Boston, MA

NPI Status: Active since June 27, 2017

Contact Information

221 LONGWOOD AVE
BOSTON, MA
ZIP 02115
Phone: (617) 732-5666

Get Directions Reviews

  • Individual
  • Female
  • Years of Experience 21
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About THEODORA PAPPA

This page provides the complete NPI Profile along with additional information for Theodora Pappa, an internist established in Boston, Massachusetts with a medical specialization in Internal Medicine and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1285154674 assigned on June 2017. The practitioner's primary taxonomy code is 207R00000X with license number 278465 (MA). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1285154674
Provider Name
DR. THEODORA PAPPA MD, PHD
Gender
Female
Entity Type
Individual
Location Address
221 LONGWOOD AVE BOSTON, MA 02115
Location Phone
(617) 732-5666
Mailing Address
221 LONGWOOD AVE BOSTON, MA 02115
Mailing Phone
(617) 732-5666
Medical School Name
OTHER
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
06-27-2017
Last Update Date
07-06-2021
Code Navigator

An internist like Theodora Pappa 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

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
278465
License State
MA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

125.071464 (IL)
2207RE0101XAllopathic & Osteopathic Physicians

Internal Medicine
Endocrinology, Diabetes & Metabolism

279830 (MA)

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

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

Medicare Participation & PECOS Enrollment Status

Theodora Pappa 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.

Theodora Pappa 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: 4183040413

    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: I20210713000795

    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)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    2 DME suppliers used 11 Medicare Claims 11 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.

Established patient office or other outpatient visit, 30-39 minutes

This 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 17 times for 14 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $36.02 for a new patient copayment and $27.79 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 02115 ZIP code area.

New Patients Visit Costs *

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

  • Average New Patient Price $144.11
  • Minimum New Patient Price $63.72
  • Maximum New Patient Price $189.86
  • Average New Patient Copayment $36.02
  • Minimum New Patient Copayment $15.93
  • Maximum New Patient Copayment $47.46

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $111.18
  • Minimum Established Patient Price $21.07
  • Maximum Established Patient Price $155.29
  • Average Established Patient Copayment $27.79
  • Minimum Established Patient Copayment $5.26
  • Maximum Established Patient Copayment $38.82

* 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.

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. Theodora Pappa is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
BRIGHAM AND WOMEN'S HOSPITAL75 FRANCIS STREET
BOSTON, MA 02115
(617) 732-5500Acute Care Hospitals

Reviews for DR. THEODORA PAPPA MD, PHD

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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.
1285154674
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22165258614
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 2 + 5 + 8 + 6 + 1 + 4 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1285154674 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
1396748463DR. NIKHEEL SHRINIVAS KOLATKAR M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)221 LONGWOOD AVE
BOSTON, MA 02115
(617) 732-7947
1205827839DR. RANDALL H PAULSEN MD
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE MEZZANINE DEPT OF PSYCHIATRY
BOSTON, MA 02115
(617) 732-6753
1720060916 JEREMIAH M SCHARF MD PHD
Individual
Psychiatry & Neurology (Neurology)221 LONGWOOD AVE
BOSTON, MA 02115
(617) 732-8060
1922081553DR. KIRK R DAFFNER MD
Individual
Psychiatry & Neurology (Neurology)221 LONGWOOD AVE
BOSTON, MA 02115
(617) 732-8060
1699750604 JEAN E MULDER MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)221 LONGWOOD AVE RFB2, ENDOCRINOLOGY DIABETES AND HYPERTENSION
BOSTON, MA 02115
(617) 632-5100
1124096920DR. AARON PHILIP NELSON PH.D.
Individual
Clinical Neuropsychologist221 LONGWOOD AVE BRIGHAM BEHAVIORAL NEUROLOGY GROUP
BOSTON, MA 02115
(617) 732-8060
1881659464 MEGHAN M SEARL PHD
Individual
Psychologist221 LONGWOOD AVE BRIGHAM BEHAVIROAL NEUROLOGY
BOSTON, MA 02115
(617) 732-8060
1740247121 DAVID JEFFREY GELTMAN MD
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE BRIGHAM AND WOMENS HOSPITAL DEPARTMENT OF PSYCHIATRY
BOSTON, MA 02115
(617) 732-8433
1871550137 EDWARD MEIGS BROWN MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)221 LONGWOOD AVE BRIGHAM AND WOMEN HOSPITAL ENDOCRINOLOGY DIABETES
BOSTON, MA 02115
(617) 732-5661
1053379099 REENA KAPOOR M.D.
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE 4TH FL/PSYCHIATRY
BOSTON, MA 02115
(617) 667-2300
1043267420 DANIEL M GRIMES M.D.
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE
BOSTON, MA 02115
(617) 667-2300
1871540104 BARRY S FOGEL MD
Individual
Psychiatry & Neurology (Neurology)221 LONGWOOD AVE BRIGHAM BEHAVIORAL NEUROLOGY
BOSTON, MA 02115
(617) 732-8231
1720027832DR. JOHN ANDREW RAINIER GRIMALDI JR. M.D.
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE RF-M56
BOSTON, MA 02115
(617) 732-6753
1033155395 DANIEL WILLIAM CRAMER MD SCD
Individual
Obstetrics & Gynecology (Gynecology)221 LONGWOOD AVE BRIGHAM AND WOMENS HOSP DEPT OF OBSTETRICS AND GYNECOLO
BOSTON, MA 02115
(617) 732-4895
1750311254 LISA ANN CARBONE MD
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE BRIGHAM AND WOMENS HOSPITAL
BOSTON, MA 02115
(617) 732-6750
1083647648BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION INC
Organization
Dermatology221 LONGWOOD AVE
BOSTON, MA 02115
(617) 732-4918
1912932906 SCOTT M MCGINNIS M.D.
Individual
Psychiatry & Neurology (Neurology)221 LONGWOOD AVE M80
BOSTON, MA 02115
(617) 732-8060
1588762496 LAURA J. MILLER
Individual
Psychiatry & Neurology (Psychiatry)221 LONGWOOD AVE BRIGHAM PSYCHIATRIC SPECIALTIES, 4TH FLOOR
BOSTON, MA 02115
(617) 732-6753
1346326535 RITA MARIE MCCARTHY RN NP
Individual
Nurse Practitioner (Adult Health)221 LONGWOOD AVE
BOSTON, MA 02115
(617) 732-7672
1538230743DR. JANIS L ANDERSON PH.D.
Individual
Psychologist (Clinical)221 LONGWOOD AVE BWH PSYCHIATRY MEZZ.
BOSTON, MA 02115
(617) 732-7993

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285154674, enumerated in the NPI registry as an "individual" on June 27, 2017

The provider is located at 221 Longwood Ave Boston, Ma 02115 and the phone number is (617) 732-5666

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 21 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. 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 $144.11 with an average copayment of $36.02 for new patient appointments. Established patients should expect a typical charge of $111.18 and an average copayment of 27.79. 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, 30-39 minutes.

The practitioner is affiliated to the following hospital(s): BRIGHAM AND WOMEN'S HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 27, 2017. 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.