SEAN HORRIGAN D.O.
NPI 1821140351
Internal Medicine in Worcester, MA


Quality Rating: 87.31 out of 100 score

NPI Status: Active since January 17, 2007

Contact Information

281 LINCOLN ST
MED STAFF SVCS
WORCESTER, MA
ZIP 01605
Phone: (508) 334-8015

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

About SEAN HORRIGAN

This page provides the complete NPI Profile along with additional information for Sean Horrigan, an internist established in Worcester, Massachusetts with a medical specialization in Internal Medicine and more than 21 years of experience. He graduated from University Of New England, College Of Osteo Medicine in 2005. The healthcare provider is registered in the NPI registry with number 1821140351 assigned on January 2007. The practitioner's primary taxonomy code is 207R00000X with license number 225555 (MA). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1821140351
Provider Name
SEAN HORRIGAN D.O.
Gender
Male
Entity Type
Individual
Location Address
281 LINCOLN ST MED STAFF SVCS WORCESTER, MA 01605
Location Phone
(508) 334-8015
Mailing Address
281 LINCOLN ST MED STAFF SVCS WORCESTER, MA 01605
Mailing Phone
(508) 334-8015
Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Graduation Year
2005
Is Sole Proprietor?
No
Enumeration Date
01-17-2007
Last Update Date
07-08-2007
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An internist like Sean Horrigan 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.

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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.
225555
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.

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

Sean Horrigan 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.

Sean Horrigan 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: 5092839209

    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: I20100825000150

    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.

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 28 times for 22 patients

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 475 times for 403 patients

Established patient office or other outpatient visit, 40-54 minutes

This 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 14 times for 14 patients

Established patient office or other outpatient visit, 40-54 minutes

This 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 348 times for 288 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial 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 33 times for 33 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial 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 55 times for 55 patients

Measurement of brain wave activity (eeg), awake and asleep

The measurement of brain wave activity, known as an EEG, records the brain's electrical signals. It's performed when you're awake and asleep to monitor your brain's functioning. It helps in diagnosing conditions like epilepsy, sleep disorders, and other neurological issues.

This service was performed 37 times for 35 patients

Measurement of brain wave activity (eeg), awake and drowsy

Measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This procedure is done when you're awake and drowsy to understand how your brain functions during different states of consciousness.

This service was performed 80 times for 76 patients

Measurement of brain wave activity (eeg), in coma or asleep

The measurement of brain wave activity, also known as an EEG, is a non-invasive test that records electrical patterns in your brain. This is done when you're asleep or in a coma, to help understand brain function and identify any abnormalities.

This service was performed 19 times for 18 patients

Needle measurement of electrical activity in arm or leg muscles, complete study

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.

This service was performed 280 times for 169 patients

Nerve conduction, 13 or more studies

Nerve conduction studies involve 13 or more tests to check the speed and strength of signals traveling between your nerves and muscles. It helps diagnose conditions affecting nerves and muscles. The test involves small shocks and may cause minor discomfort.

This service was performed 46 times for 45 patients

Nerve conduction, 5-6 studies

Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.

This service was performed 22 times for 22 patients

Nerve conduction, 9-10 studies

Nerve conduction studies involve sending small electrical shocks through the skin to measure how quickly nerves transmit signals. This helps detect nerve damage. 9-10 studies mean this process will be repeated on different nerves to gather comprehensive data.

This service was performed 93 times for 93 patients

New patient office or other outpatient visit, 45-59 minutes

This 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 179 times for 179 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 49 times for 49 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $33.61 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 01605 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 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.

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 87.31, 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.

  • Final Score: 87.31 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.

  • Quality Score: 76.93

    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.

  • 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. Sean Horrigan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CAPE COD HOSPITAL27 PARK STREET
HYANNIS, MA 02601
(508) 771-1800Acute Care Hospitals
FALMOUTH HOSPITAL67 & 100 TER HEUN DRIVE
FALMOUTH, MA 02540
(508) 548-5300Acute Care 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.
1821140351
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2841240310
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 4 + 1 + 2 + 4 + 0 + 3 + 1 + 0 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1821140351 is valid because the calculated check digit 1 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
1740264043 DIANNE L SILVESTRI M.D.
Individual
Dermatology281 LINCOLN ST DEPARTMENT OF DERMATOLOGY
WORCESTER, MA 01605
(508) 334-5979
1659344950MS. DORIS M GOULD NP
Individual
Nurse Practitioner281 LINCOLN ST DEPARTMENT OF ORTHOPEDICS
WORCESTER, MA 01605
(508) 334-5916
1609841014MR. ROLANDO A. PEREA JR. N.P.
Individual
Nurse Practitioner281 LINCOLN ST
WORCESTER, MA 01605
(508) 793-6000
1962463687MS. CAROLYN JO MCLAUGHLIN NP
Individual
Nurse Practitioner281 LINCOLN ST PRE ADMISSION TESTING
WORCESTER, MA 01605
(508) 334-5734
1992747976 A JEROME PHILBIN M.D.
Individual
Orthopaedic Surgery281 LINCOLN ST
WORCESTER, MA 01605
(508) 757-1431
1033212105MR. EDWARD W ARNDT III NP
Individual
Nurse Practitioner281 LINCOLN ST EICU
WORCESTER, MA 01605
(508) 793-6310
1952495897MS. LINDA THERESA DATTIS CRNA
Individual
Nurse Anesthetist, Certified Registered281 LINCOLN ST DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01605
(508) 334-5897
1093800351MS. ALICE V NOLEN-WALSTON CRNA
Individual
Nurse Anesthetist, Certified Registered281 LINCOLN ST DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01605
(508) 334-1000
1992895189 JESSICA A COSENZA PA
Individual
Physician Assistant281 LINCOLN ST DEPARTMENT OF DERMATOLOGY
WORCESTER, MA 01605
(508) 334-5979
1952468514DR. EDWARD J. DEANGELO M.D.
Individual
Radiology (Diagnostic Radiology)281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-1131
1700943214DR. MARTHA MCLOUGHLIN M.D.
Individual
Family Medicine281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-1131
1528117330DR. BATHSHEEBA ANDRABI M.D.
Individual
Internal Medicine281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-8018
1134278955DR. CHRISTINA BENOU M.D.
Individual
Internal Medicine (Infectious Disease)281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1790835072DR. LI-FEN CHEN M.D.
Individual
Internal Medicine281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1407907553 LARA FORD M.D.
Individual
Pediatrics281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1336290469DR. WILLIAM ENGELMAN M.D.
Individual
Pediatrics281 LINCOLN ST MED STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1013068147DR. THOMAS EVANS M.D.
Individual
Emergency Medicine281 LINCOLN ST MED STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1912059429 PEYTON HAYS M.D.
Individual
Orthopaedic Surgery281 LINCOLN ST MED STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1457404493DR. KRISTA JOHANSEN M.D.
Individual
Pathology (Anatomic Pathology)281 LINCOLN ST MEDICAL STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015
1710030754DR. PARISA KABOLI M.D.
Individual
Internal Medicine281 LINCOLN ST MED STAFF SVCS
WORCESTER, MA 01605
(508) 334-8015

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821140351, enumerated in the NPI registry as an "individual" on January 17, 2007

The provider is located at 281 Lincoln St Med Staff Svcs Worcester, Ma 01605 and the phone number is (508) 334-8015

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

The provider has more than 21 years of experience. He graduated from University Of New England, College Of Osteo Medicine in 2005.

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.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

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 $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: Critical care, first 30-74 minutes, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Established patient office or other outpatient visit, 40-54 minutes, Initial hospital inpatient care per day, typically 50 minutes, Initial hospital inpatient care per day, typically 70 minutes, Measurement of brain wave activity (eeg), awake and asleep, Measurement of brain wave activity (eeg), awake and drowsy, Measurement of brain wave activity (eeg), in coma or asleep, Needle measurement of electrical activity in arm or leg muscles, complete study, Nerve conduction, 13 or more studies, Nerve conduction, 5-6 studies, Nerve conduction, 9-10 studies, New patient office or other outpatient visit, 45-59 minutes and New patient office or other outpatient visit, 60-74 minutes.

The practitioner is affiliated to the following hospital(s): CAPE COD HOSPITAL and FALMOUTH 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 January 17, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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.