PAUL MIRONE
NPI 1043219850
Family Medicine in Erie, PA

Active since July 14, 2005PECOS EnrolledAccepts Medicare Assignment
79.55/100
CMS Quality Rating
1600 PENINSULA DR STE 9, SUITE 9, ERIE, PA 16505(814) 877-7035 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 25, 2021, Mar 27, 2020 (2 updates tracked since 2020).

About Paul Mirone NPPES

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

PAUL MIRONE (NPI 1043219850) is an individual family medicine provider in Erie, Pennsylvania, licensed in Pennsylvania (MD063285L) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Upmc Hamot, and is a graduate of Ohio State University College Of Medicine (1991).

NPPES Registry Identity

NPI1043219850
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePAUL MIRONE
Location Address1600 PENINSULA DR STE 9, SUITE 9Erie, PA 16505-4261
Mailing Address1600 Peninsula Dr Ste 9, Suite 9Erie, PA 16505-4261
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 1991
Enumeration DateJuly 14, 2005
Last NPPES UpdateMarch 25, 20212 updates tracked since enumeration
NPPES CertifiedMarch 27, 2020
NPI 1043219850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in PA · MD063285L
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1600 PENINSULA DR STE 9, Erie, PA 16505

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Paul Mirone 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 ID9739121427
PECOS Enrollment IDI20050524000045
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.

Areas of Expertise CMS Part B claims 2

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.
136 services118 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
71 services67 patients

Hospital Affiliations CMS Care Compare

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

Upmc Hamot

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390063
Location201 State StreetErie, PA 16550 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16505 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
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.

79.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.36
Promoting Interoperability100
Improvement Activities40
Cost67.48

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers32 claims57 services$5.32 avg. paid by Medicare
Skin barrier; solid, 4 x 4 or equivalent; each A4362
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$3.35 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers11 claims11 services$37.26 avg. paid by Medicare
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each A5057
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$8.50 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers16 claims87 services$19.45 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers21 claims21 services$55.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1600 PENINSULA DR STE 9
ERIE, PA 16505
Home Health
1600 PENINSULA DR STE 9
ERIE, PA 16505
Family Medicine
1600 PENINSULA DR STE 9
ERIE, PA 16505

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 Paul Mirone's NPI number?

The NPI number for Paul Mirone is 1043219850. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Paul Mirone located?

Paul Mirone practices at 1600 Peninsula Dr Ste 9 Suite 9, Erie, PA 16505. The listed phone number is (814) 877-7035.

What is Paul Mirone's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Paul Mirone enrolled in Medicare?

Yes. Paul Mirone 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.

Is Paul Mirone affiliated with any hospitals?

According to CMS data, Paul Mirone is affiliated with Upmc Hamot.

When was this NPI record last updated?

The NPPES record for Paul Mirone was last updated on March 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.