JOHN WORDEN M.D.
NPI 1326020223
Family Medicine in Gardner, MA
NPI Status: Active since November 16, 2005
Contact Information
250 GREEN ST
GARDNER, MA
ZIP 01440
Phone: (978) 630-6445
Fax: (978) 630-3603
- Individual
- Male
- Years of Experience 30
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOHN WORDEN
This page provides the complete NPI Profile along with additional information for John Worden, a primary care provider established in Gardner, Massachusetts with a medical specialization in Family Medicine and more than 30 years of experience. He graduated from University Of Massachusetts Medical School in 1996. The healthcare provider is registered in the NPI registry with number 1326020223 assigned on November 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 158996 (MA). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1326020223
- Provider Name
- JOHN WORDEN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 250 GREEN ST GARDNER, MA 01440
- Location Phone
- (978) 630-6445
- Location Fax
- (978) 630-3603
- Mailing Address
- 250 GREEN ST GARDNER, MA 01440
- Mailing Phone
- (978) 630-6445
- Mailing Fax
- (978) 630-3603
- Medical School Name
- UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
- Graduation Year
- 1996
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-16-2005
- Last Update Date
- 07-08-2007
- Code Navigator
A primary care provider (PCP) like John Worden sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 158996
- License State
- MA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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
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 |
|---|---|---|---|
| G95736 | MEDICARE UPIN (02) | ||
| 3196801 | MEDICAID (05) | MA | |
| A36923 | MEDICARE ID-TYPE UNSPECIFIED (04) | MA |
Medicare Participation & PECOS Enrollment Status
John Worden 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.
John Worden 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: 9638168974
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: I20040727000860
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)
5 DME suppliers used 22 Medicare Claims 79 Services Paid
DME-Other DME (DE001N)
Full face mask used with positive airway pressure device, each (HCPCS:A7030)
3 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Other DME (DE001N)
Face mask interface, replacement for full face mask, each (HCPCS:A7031)
3 DME suppliers used 14 Medicare Claims 42 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
3 DME suppliers used 17 Medicare Claims 102 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 36 Medicare Claims 36 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.
Administration of influenza virus vaccine
Administration of pneumococcal vaccine
Advance care planning, first 30 minutes
Annual depression screening, 15 minutes
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Established patient office or other outpatient visit, 10-19 minutes
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
Influenza vaccine split virus, preservative free
Insertion of needle into vein for collection of blood sample
Melanoma (skin cancer) excision
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Pneumococcal vaccine, 23-valent
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Telephone medical discussion with physician, 11-20 minutes
Telephone medical discussion with physician, 5-10 minutes
Urinalysis, manual test
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 82 times for 81 patientsThe pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
This service was performed 23 times for 22 patientsAdvance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
This service was performed 21 times for 21 patientsAn annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
This service was performed 109 times for 109 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 113 times for 113 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 37 times for 34 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 146 times for 100 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 421 times for 174 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 30 times for 25 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 76 times for 76 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 100 times for 77 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
This service was performed 30 times for 15 patientsThe 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.
This service was performed 20 times for 20 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 31 times for 30 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 48 times for 43 patientsA telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
This service was performed 23 times for 22 patientsA urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
This service was performed 32 times for 28 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 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 01440 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.7
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.67
- 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.
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. John Worden is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| HEYWOOD HOSPITAL | 242 GREEN STREET GARDNER, MA 01440 | (978) 632-3420 | Acute Care Hospitals | |
| ATHOL MEMORIAL HOSPITAL | 2033 MAIN STREET ATHOL, MA 01331 | (978) 249-3511 | Critical Access 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 | 3 | 2 | 6 | 0 | 2 | 0 | 2 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 4 | 6 | 0 | 2 | 0 | 2 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 4 + 6 + 0 + 2 + 0 + 2 + 4 + 24 = 47 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 47 = 3 | 3 | ||||||||
The NPI number 1326020223 is valid because the calculated check digit 3 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 |
|---|---|---|---|
| 1821095365 | DR. FRANCIS ANTHONY GAROFALO M.D. Individual | Urology | 250 GREEN ST SUITE 210 GARDNER, MA 01440 (978) 669-5522 |
| 1154320984 | AYAZ TARIQ MALIK M.D. Individual | Internal Medicine (Gastroenterology) | 250 GREEN ST STE 212 GARDNER, MA 01440 (978) 669-5522 |
| 1992792980 | JEFFREY D. BLAKE M.D. Individual | Obstetrics & Gynecology | 250 GREEN ST GARDNER, MA 01440 (978) 630-5050 |
| 1740277730 | ANDREA M. DAMOUR M.D. Individual | Obstetrics & Gynecology | 250 GREEN ST GARDNER, MA 01440 (978) 630-5050 |
| 1649268277 | CHRISTINE M. MCMAHON FNP-C Individual | Nurse Practitioner (Family) | 250 GREEN ST GARDNER, MA 01440 (978) 630-5050 |
| 1467441279 | MICHAEL J. MUTCHLER M.D. Individual | Family Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 669-0199 |
| 1104815919 | MICHELE C. PARKER M.D. Individual | Family Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 669-0199 |
| 1194715268 | JOHN M. SKRZYPCZAK M.D. Individual | Emergency Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 630-6280 |
| 1548250657 | MOTKAR V. REDDY M.D. Individual | Internal Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 632-4324 |
| 1790776730 | ROBERT J. TERLATO M.D. Individual | Internal Medicine (Cardiovascular Disease) | 250 GREEN ST SUITE 110 GARDNER, MA 01440 (978) 630-5020 |
| 1659352706 | REBECCA M. WORDEN M.D. Individual | Family Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 632-6445 |
| 1982679601 | FRANCIS W. SWEENEY M.D. Individual | Family Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 630-4455 |
| 1831168830 | DAVID C. FLEMMING MD Individual | Anesthesiology | 250 GREEN ST GARDNER, MA 01440 (978) 630-6267 |
| 1366411316 | CHAIR CITY FAMILY MEDICINE, PC Organization | Family Medicine | 250 GREEN ST GARDNER, MA 01440 (978) 630-4455 |
| 1366466344 | PETER BRASSARD M.D. Individual | Orthopaedic Surgery | 250 GREEN ST GARDNER, MA 01440 (978) 632-0800 |
| 1356462410 | TRICIA VORDERSTRASSE MD PC Organization | Family Medicine | 250 GREEN ST SUITE 1 06 GARDNER, MA 01440 (978) 249-1791 |
| 1760601082 | CYRUS VAKILI M.D. Individual | Surgery | 250 GREEN ST GARDNER, MA 01440 (978) 630-4452 |
| 1760698500 | STEVEN K. BRANCH, MD, PHD, PC Organization | Surgery | 250 GREEN ST GARDNER, MA 01440 (978) 630-5040 |
| 1811183254 | MICHAEL AZZONI, MD Organization | Orthopaedic Surgery | 250 GREEN ST GARDNER, MA 01440 (978) 632-0383 |
| 1780852608 | GARDNER EYE ASSOCIATES INC Organization | Ophthalmology | 250 GREEN ST SUITE 106 GARDNER, MA 01440 (978) 632-7626 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326020223, enumerated in the NPI registry as an "individual" on November 16, 2005
The provider is located at 250 Green St Gardner, Ma 01440 and the phone number is (978) 630-6445
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 30 years of experience. He graduated from University Of Massachusetts Medical School in 1996.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare 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 $90.7 with an average copayment of $22.67 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: Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Advance care planning, first 30 minutes, Annual depression screening, 15 minutes, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 10-19 minutes, 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, Influenza vaccine split virus, preservative free, Insertion of needle into vein for collection of blood sample, Melanoma (skin cancer) excision, Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional, Pneumococcal vaccine, 23-valent, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Telephone medical discussion with physician, 11-20 minutes, Telephone medical discussion with physician, 5-10 minutes and Urinalysis, manual test.
The practitioner is affiliated to the following hospital(s): HEYWOOD HOSPITAL and ATHOL MEMORIAL 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 November 16, 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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