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THOMAS SCALFAROTTO DO
NPI 1003128067
Surgery in Gardner, MA

Active since July 07, 2010PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
250 GREEN ST STE 208, GARDNER, MA 01440(978) 630-6130 Get Directions Write a Review

NPPES record last updated: January 24, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Thomas Scalfarotto Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS SCALFAROTTO DO (NPI 1003128067) is an individual surgery provider in Gardner, Massachusetts, licensed in Massachusetts (267570) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Emerson Hospital -, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1003128067
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameTHOMAS SCALFAROTTOCredential: DO
Location Address250 GREEN ST STE 208Gardner, MA 01440-1377
Mailing Address98 Oak St, Apt. 610Lindenwold, NJ 08021-2483 · (707) 319-1562
Phone(978) 630-6130
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 7, 2010
Last NPPES UpdateJanuary 24, 2020
✔ NPI 1003128067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MA · 267570
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
250 GREEN ST STE 208, Gardner, MA 01440
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas Scalfarotto Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436372422
PECOS Enrollment IDI20161021000095
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Thomas Scalfarotto reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Henry Heywood Memorial Hospital
Same address
Hospitalist
242 GREEN ST
Gardner, MA 01440
  • Reassigned Medicare billing, Massachusetts enrollment
  • 344 clinicians in this Medicare group
NPI 1205448701 (978) 630-6944
Heywood Medical Group Inc.
Same address
General Practice
242 GREEN ST
Gardner, MA 01440
  • Reassigned Medicare billing, Massachusetts enrollment
  • 218 clinicians in this Medicare group
NPI 1699762286 (978) 630-5076
Athol Memorial Hospital Incorporated
11 mi
Critical Access
2033 MAIN STREET
Athol, MA 01331
  • Reassigned Medicare billing, Massachusetts enrollment
  • 324 clinicians in this Medicare group
NPI 1336120047 (978) 249-3511
Emerson Practice Associates, Inc.
33 mi
Internal Medicine
133 OLD ROAD TO NINE ACRE CORNER
Concord, MA 01742
  • Reassigned Medicare billing, Massachusetts enrollment
  • 451 clinicians in this Medicare group
NPI 1508020199 (978) 287-3022

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
63 services44 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
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.
36 services36 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
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.
20 services20 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
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.
15 services14 patients
Repair of groin hernia (5 years or older) 49505
Repair of a groin hernia is a procedure aimed at fixing an abnormal bulge that can occur in the area between your abdomen and thigh. This condition happens when tissue pushes through a weak spot in your lower abdominal wall. The repair procedure returns this tissue back to its proper place.
14 services14 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
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.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emerson Hospital -

Acute Care Hospitals · W Concord, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220084
Location133 Old Road To 9 Acre CornerW Concord, MA 01742 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01440 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%102 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%353 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
43%575 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%575 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
17%575 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
25%575 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Scalfarotto's NPI number?

The NPI number for Thomas Scalfarotto is 1003128067. It was assigned to this individual provider in the NPPES registry on July 7, 2010.

Where is Thomas Scalfarotto located?

Thomas Scalfarotto practices at 250 Green St Ste 208, Gardner, MA 01440. The listed phone number is (978) 630-6130.

What is Thomas Scalfarotto's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Thomas Scalfarotto enrolled in Medicare?

Yes. Thomas Scalfarotto is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Thomas Scalfarotto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Scalfarotto reassigns Medicare benefits to 4 organizations: Henry Heywood Memorial Hospital (Gardner, MA), Heywood Medical Group Inc. (Gardner, MA), Athol Memorial Hospital Incorporated (Athol, MA) and Emerson Practice Associates, Inc. (Concord, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Scalfarotto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Scalfarotto accept?

Health plans from Anthem Blue Cross and Blue Shield and Taro Health list Thomas Scalfarotto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Thomas Scalfarotto affiliated with any hospitals?

According to CMS data, Thomas Scalfarotto is affiliated with Emerson Hospital -.

When was this NPI record last updated?

The NPPES record for Thomas Scalfarotto was last updated on January 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.