DR. SUSAN ALICIA HILBURN M.D.
NPI 1396772679
Internal Medicine - Hospice and Palliative Medicine in Burlington, MA
Quality Rating: 90.7 out of 100 score
NPI Status: Active since June 26, 2006
Contact Information
LAHEY HOSPITAL & MEDICAL CTR
41 MALL ROAD
BURLINGTON, MA
ZIP 01805
Phone: (781) 744-3839
Fax: (781) 744-1597
- Individual
- Female
- Years of Experience 26
- Internal Medicine
- Hospice and Palliative Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SUSAN HILBURN
This page provides the complete NPI Profile along with additional information for Susan Hilburn, an internist established in Burlington, Massachusetts with a medical specialization in Internal Medicine, focusing in hospice and palliative medicine and more than 26 years of experience. She graduated from Mercer University School Of Medicine in 2000. The healthcare provider is registered in the NPI registry with number 1396772679 assigned on June 2006. The practitioner's primary taxonomy code is 207RH0002X with license number 246012 (MA). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1396772679
- Provider Name
- DR. SUSAN ALICIA HILBURN M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- LAHEY HOSPITAL & MEDICAL CTR 41 MALL ROAD BURLINGTON, MA 01805
- Location Phone
- (781) 744-3839
- Location Fax
- (781) 744-1597
- Mailing Address
- LAHEY HOSPITAL & MEDICAL CTR 41 MALL ROAD BURLINGTON, MA 01805
- Mailing Phone
- (781) 744-3839
- Mailing Fax
- (781) 744-1597
- Medical School Name
- MERCER UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2000
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-26-2006
- Last Update Date
- 01-04-2019
- Code Navigator
An internist like Susan Hilburn 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 Hospice and Palliative Medicine
- Taxonomy Code
- 207RH0002X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 246012
- License State
- MA
- Taxonomy Description
- An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
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
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 |
|---|---|---|---|
| 3074299 | MEDICAID (05) | NH | |
| 110096801A | MEDICAID (05) | MA |
Medicare Participation & PECOS Enrollment Status
Susan Hilburn 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.
Susan Hilburn 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: 3779478995
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: I20170302002038
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
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.
Advance care planning, first 30 minutes
Follow-up hospital inpatient care per day, typically 15 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Initial hospital inpatient care per day, typically 30 minutes
Initial hospital inpatient care per day, typically 50 minutes
Advance 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 48 times for 38 patientsFollow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
This service was performed 22 times for 18 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 62 times for 37 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 91 times for 45 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 51 times for 47 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 40 times for 38 patientsOverall 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. Susan Hilburn is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON | 41 & 45 MALL ROAD BURLINGTON, MA 01803 | (781) 744-5100 | Acute Care Hospitals |
Reviews for DR. SUSAN ALICIA HILBURN M.D.
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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 | 9 | 6 | 7 | 7 | 2 | 6 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 14 | 7 | 4 | 6 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 1 + 4 + 7 + 4 + 6 + 1 + 4 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1396772679 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 16 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1134274251 | MR. TIMOTHY PAUL MCGRATH N.P. Individual | Nurse Practitioner (Gerontology) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-7000 |
| 1184666315 | DR. MARK ANTHONY GENDREAU M.D. Individual | Emergency Medicine | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD BURLINGTON, MA 01805 (978) 538-4600 |
| 1285083725 | JOSEPH R ACKERMAN LICSW Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-5100 |
| 1477903508 | LISA CARLSON-HILL Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1962852004 | JAYNE KRASLIN Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1568813376 | MERLE KUSHNER LICSW Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1083065890 | SUSAN LADD MSW Individual | Social Worker | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1225489032 | JENNIFER VANDERLINDEN LICSW Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1295186732 | NANCY PORTER LICSW Individual | Social Worker (Clinical) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8013 |
| 1780975177 | JESSICA CARLY SOPHIA MINTZ D.O. Individual | Internal Medicine (Cardiovascular Disease) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8460 |
| 1750524278 | DR. ALEXANDER PANDA M.D. Individual | Internal Medicine (Critical Care Medicine) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8480 |
| 1205132990 | DANIEL VARDEH M.D. Individual | Psychiatry & Neurology (Pain Medicine) | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8000 |
| 1043478241 | DR. AMANDA G POWELL MD Individual | Internal Medicine (Obesity Medicine) | LAHEY HOSPITAL & MEDICAL CTR 50 MALL RD. G03 BURLINGTON, MA 01805 (855) 934-4488 |
| 1780627505 | DR. MEREDITH MATTISON PACE M.D. Individual | Anesthesiology | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-8132 |
| 1215112867 | ANDREEA GOLDBERGER M.D. Individual | Internal Medicine | LAHEY HOSPITAL & MEDICAL CTR 41 MALL ROAD BURLINGTON, MA 01805 (781) 744-8000 |
| 1073749412 | PARAG VOHRA MD Individual | Internal Medicine | LAHEY HOSPITAL & MEDICAL CTR 41 MALL RD. BURLINGTON, MA 01805 (781) 744-3839 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396772679, enumerated in the NPI registry as an "individual" on June 26, 2006
The provider is located at Lahey Hospital & Medical Ctr 41 Mall Road Burlington, Ma 01805 and the phone number is (781) 744-3839
The provider's speciality is Internal Medicine with taxonomy code 207RH0002X with a focus in Hospice and Palliative Medicine
The provider has more than 26 years of experience. She graduated from Mercer University School Of Medicine in 2000.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, 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.
The most common procedures or services performed by this practitioner are: Advance care planning, first 30 minutes, Follow-up hospital inpatient care per day, typically 15 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Initial hospital inpatient care per day, typically 30 minutes and Initial hospital inpatient care per day, typically 50 minutes.
The practitioner is affiliated to the following hospital(s): 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 June 26, 2006. 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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