|Provider Name||DONALD MONTEIRO M.D.|
|Location Address||1 CITY HALL PLZ MELROSE, MA 02176|
|Location Phone||(781) 662-4390|
|Mailing Address||1 CITY HALL PLZ MELROSE, MA 02176|
|NPI Entity Type||Individual|
|Medical School Name||UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL|
|Is Sole Proprietor?||No|
|Last Update Date||11-06-2013|
Women's health care providers like Donald Monteiro M.d. treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.Donald Monteiro 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.
Donald Monteiro is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Melrosewakefield Healthcare and Lowell General Hospital.
The typical physician office visit costs for Medicare beneficiaries in this area are: $37.51 for a new patient copayment and $20.59 for an established patient copayment.
The primary taxonomy code defines the provider type, classification, and 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||Obstetrics & Gynecology|
|Type||Allopathic & Osteopathic Physicians|
|Taxonomy Description||An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.|
The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:
- Tufts Health Plan
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
DONALD MONTEIRO M.D.
1 CITY HALL PLZ
Phone: (781) 662-4390
Fax: (781) 662-4395
DONALD MONTEIRO M.D.
1 CITY HALL PLZ
Phone: (781) 662-4390
Fax: (781) 662-4395
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||8022064328|
|PECOS Enrollment ID||I20050330000354|
|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 order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 02176 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99204|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99213|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 48Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)
- 34Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
- 26Stool analysis for blood to screen for colon tumors (HCPCS:82270)
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Donald Monteiro is affiliated with the following medical facilities:
|Hospital Name||Address||Phone||Hospital Type||CMS Certification Number (CCN)||Overall Rating|
|MELROSEWAKEFIELD HEALTHCARE||585 LEBANON STREET|
MELROSE, MA 2176
|(781) 979-3000||Acute Care Hospitals||220070|
|LOWELL GENERAL HOSPITAL||295 VARNUM AVENUE|
LOWELL, MA 1854
|(978) 937-6000||Acute Care Hospitals||220063|
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
|Identifier||Type / Code||Identifier State||Identifier Issuer|
|A58725||MEDICARE UPIN (02)||MA|
|J06056||MEDICARE ID-TYPE UNSPECIFIED (04)||MA|
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.|
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.|
|2 + 0 + 2 + 3 + 0 + 8 + 0 + 6 + 0 + 24 = 45|
|Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.|
|50 - 45 = 5||5|
The NPI number 1013080605 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
What is Donald Monteiro M.D. NPI number?
The NPI number assigned to Donald Monteiro M.D. is 1013080605, registered as an "individual" on November 15, 2006
Where is Donald Monteiro M.D. located?
The provider is located at 1 City Hall Plz Melrose, Ma 02176 and the phone number is (781) 662-4390
Which is Donald Monteiro M.D. specialty?
The provider's speciality is Obstetrics & Gynecology
How many years of experience does Donald Monteiro M.D. have?
The provider has more than 41 years of experience. He graduated from University Of Massachusetts Medical School in 1982.
What insurance does Donald Monteiro M.D. accept?
The provider might be accepting Medicaid, Medicare and Tufts Health Plan. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.
Is Donald Monteiro M.D. registered in PECOS?
Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare 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.
How much is a visit to Donald Monteiro M.D.?
Medicare beneficiaries should expect a typical cost of $150.04 with an average copayment of $37.51 for new patient appointments. Established patients should expect a typical charge of $82.39 and an average copayment of 20.59. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Donald Monteiro M.D.?
The most common procedures or services performed by this practitioner are: Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory, Cervical or vaginal cancer screening; pelvic and clinical breast examination and Stool analysis for blood to screen for colon tumors.
Is Donald Monteiro M.D. affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: MELROSEWAKEFIELD HEALTHCARE and LOWELL GENERAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Donald Monteiro M.D. was last updated on November 15, 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]
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 at: [email protected]