SETH T DAHLBERG M.D.
NPI 1639152564
Internal Medicine - Cardiovascular Disease in Worcester, MA
Quality Rating: 90.62 out of 100 score
NPI Status: Active since November 23, 2005
Contact Information
55 LAKE AVE N
DEPARTMENT OF CARDIOVASCULAR & NUCLEAR MEDICINE
WORCESTER, MA
ZIP 01655
Phone: (508) 334-3452
Fax: (508) 856-4571
- Individual
- Male
- Internal Medicine
- Cardiovascular Disease
- Accepts Insurance
- PECOS Enrolled
About SETH DAHLBERG
This page provides the complete NPI Profile along with additional information for Seth Dahlberg, an internist established in Worcester, Massachusetts with a medical specialization in Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1639152564 assigned on November 2005. The practitioner's primary taxonomy code is 207RC0000X with license number 57266 (MA). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1639152564
- Provider Name
- SETH T DAHLBERG M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 55 LAKE AVE N DEPARTMENT OF CARDIOVASCULAR & NUCLEAR MEDICINE WORCESTER, MA 01655
- Location Phone
- (508) 334-3452
- Location Fax
- (508) 856-4571
- Mailing Address
- PO BOX 415348 BOSTON, MA 02241
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-23-2005
- Last Update Date
- 10-28-2020
- Code Navigator
An internist like Seth Dahlberg 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 Cardiovascular Disease
- Taxonomy Code
- 207RC0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 57266
- License State
- MA
- Taxonomy Description
- An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
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 |
|---|---|---|---|
| 110048569A | MEDICAID (05) | MA |
Medicare Participation & PECOS Enrollment Status
Seth Dahlberg 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, 30-39 minutes
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, 30 minutes or less
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Ultrasound of heart blood flow, valves and chambers, follow-up
Ultrasound of heart with color-depicted blood flow, rate and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report
Ultrasound of heart, follow-up
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 197 times for 161 patientsAn exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
This service was performed 53 times for 53 patientsAn exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.
This service was performed 53 times for 53 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 51 times for 28 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 22 times for 14 patientsHospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
This service was performed 11 times for 11 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 23 times for 22 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 30 times for 29 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 25 times for 25 patientsNuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
This service was performed 37 times for 37 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 3,127 times for 2,498 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 98 times for 95 patientsThis procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.
This service was performed 50 times for 50 patientsAn ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.
This service was performed 56 times for 56 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 418 times for 415 patientsThis is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
This service was performed 39 times for 39 patientsThis procedure involves using ultrasound technology to create images of your heart while you rest, exercise, or undergo drug-induced stress. An ECG continuously monitors your heart's electrical activity. It helps doctors assess heart health and function.
This service was performed 47 times for 47 patientsA follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
This service was performed 45 times for 45 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 01655 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.47
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.61
- 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 99213
- Average Established Patient Price $73.22
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $18.3
- 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.
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 90.62, 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: 90.62 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: 80.1
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.
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Promoting Interoperability Score: 74.87
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.
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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 | 6 | 3 | 9 | 1 | 5 | 2 | 5 | 6 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 5 | 4 | 5 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 5 + 4 + 5 + 1 + 2 + 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 = 4 | 4 | ||||||||
The NPI number 1639152564 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 |
|---|---|---|---|
| 1457352775 | DR. SARAH BETH SAXER PHARMD Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N UMASS MED CENTER DEPT OF PHARMACY WORCESTER, MA 01655 (508) 856-2763 |
| 1891797361 | MARTHA LAROSE SAMPSON CRNA Individual | Nurse Anesthetist, Certified Registered | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1902899370 | LINDA A PAPE M.D. Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N CARDIOLOGY WORCESTER, MA 01655 (508) 856-3050 |
| 1124013271 | DR. DALE E RAUCH M.D. Individual | Psychiatry & Neurology (Psychiatry) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-6580 |
| 1225025562 | DR. MAICHI T TRAN PHARM.D. Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-1618 |
| 1215925516 | JESSICA L DOUGLAS MS Individual | Genetic Counselor, MS | 55 LAKE AVE N S1-710 WORCESTER, MA 01655 (508) 334-3517 |
| 1295723310 | DR. JULIANNE PATRICIA HUBER MD Individual | Emergency Medicine | 55 LAKE AVE N WORCESTER, MA 01655 (508) 421-1400 |
| 1609866607 | ELLEN M GRAVALLESE M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 334-5224 |
| 1497745806 | DR. ABIGAIL ADAMS M.D. Individual | Internal Medicine | 55 LAKE AVE N DEPARTMENT OF GENERAL MEDICINE WORCESTER, MA 01655 (508) 856-2731 |
| 1710977046 | GAMZE AYATA MD Individual | Pathology (Anatomic Pathology) | 55 LAKE AVE N DEPARTMENT OF PATHOLOGY WORCESTER, MA 01655 (508) 793-6100 |
| 1821088139 | DR. MARIANNE E FELICE M.D. Individual | Pediatrics (Adolescent Medicine) | 55 LAKE AVE N DEPARTMENT OF PEDIATRIC ADOLESCENT MEDICINE WORCESTER, MA 01655 (508) 856-3199 |
| 1437140308 | JOHN PULLERITS M.D. Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1558352492 | DIANA I. KOUZNETSOV MD Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1174514764 | OSCAR EPHRAM STAROBIN MD Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-3603 |
| 1942291570 | DR. STANLEY K TAM MD Individual | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 55 LAKE AVE N DEPARTMENT OF SURGERY WORCESTER, MA 01655 (508) 334-3962 |
| 1558352922 | MICHAEL C. BUTLER MD Individual | Emergency Medicine | 55 LAKE AVE N DEPARTMENT OF EMERGENCY MEDICINE WORCESTER, MA 01655 (508) 421-1400 |
| 1841281078 | DR. RUBEN PERALTA M.D. Individual | Surgery (Surgical Critical Care) | 55 LAKE AVE N DEPARTMENT OF SURGICAL CRITICAL CARE WORCESTER, MA 01655 (508) 856-5288 |
| 1598746653 | ROBERT B ZURIER M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N DEPARTMENT OF RHEUMATOLOGY WORCESTER, MA 01655 (508) 856-6246 |
| 1174504229 | JUDITH A STEBULIS M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N DEPARTMENT OF RHEUMATOLOGY WORCESTER, MA 01655 (508) 334-5224 |
| 1265413132 | DR. SHAN LU M.D. Individual | Internal Medicine | 55 LAKE AVE N DEPARTMENT OF INTERNAL MEDICINE WORCESTER, MA 01655 (508) 856-6791 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639152564, enumerated in the NPI registry as an "individual" on November 23, 2005
The provider is located at 55 Lake Ave N Department Of Cardiovascular & Nuclear Medicine Worcester, Ma 01655 and the phone number is (508) 334-3452
The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease
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.
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.
Medicare beneficiaries should expect a typical cost of $134.47 with an average copayment of $33.61 for new patient appointments. Established patients should expect a typical charge of $73.22 and an average copayment of 18.3. 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, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician, Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Hospital discharge day management, 30 minutes or less, Initial hospital inpatient care per day, typically 50 minutes, Initial hospital inpatient care per day, typically 70 minutes, New patient office or other outpatient visit, 45-59 minutes, Nuclear medicine studies of heart muscle at rest and with stress and spect, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, Ultrasound of heart blood flow, valves and chambers, follow-up, Ultrasound of heart with color-depicted blood flow, rate and valve function, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function, Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report and Ultrasound of heart, follow-up.
This NPI record was last updated on November 23, 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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