Podiatrist - Foot Surgery in Butler, NJ


Paul Palmarozzo is a provider established in Butler, New Jersey and his medical specialization is Podiatrist with a focus in foot surgery with more than 37 years of experience. He graduated from New York College Of Podiatric Medicine in 1986. The NPI number of this provider is 1063574929 and was assigned on December 2006. The practitioner's primary taxonomy code is 213ES0131X with license number 25MD00175800 (NJ). The provider is registered as an individual and his NPI record was last updated 15 years ago.

Location Address9 CAREY AVE SUITE 300 BUTLER, NJ 07405
Location Phone(973) 838-8885
Mailing Address9 CAREY AVE SUITE 300 BUTLER, NJ 07405
NPI Entity TypeIndividual
Graduation Year1986
Is Sole Proprietor?Yes
Enumeration Date12-15-2006
Last Update Date08-07-2008

Paul Palmarozzo 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) and a Home Health Agency (HHA).

Paul Palmarozzo 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.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 60, 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.

Primary Taxonomy

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.

Taxonomy Code213ES0131X
TypePodiatric Medicine & Surgery Service Providers
SpecializationFoot Surgery
License No.25MD00175800
License StateNJ

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

ZIP 07405
Phone: (973) 838-8885

Get Directions

Mailing Address

ZIP 07405
Phone: (973) 838-8885

Location Map

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 ID2769546407
PECOS Enrollment IDI20090126000273
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 ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's 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.

MIPS Measure Score Weight Score
Quality 40% N/A
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 (PI) 25% N/A
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 15% N/A
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 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 20% 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.
MIPS Final Score - 60
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.

Clinician Utilization

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.

  • 553Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • 511Removal of 2 to 4 thickened skin growths (HCPCS:11056)
  • 281Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)
  • 63Removal of single thickened skin growth (HCPCS:11055)

Additional Identifiers

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
1091204MEDICAID (05)NJ

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 + 1 + 2 + 3 + 1 + 0 + 7 + 8 + 9 + 4 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1063574929 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
Podiatrist (Foot Surgery)9 CAREY AVE SUITE 300
BUTLER, NJ 07405
(973) 838-8885
Dentist (General Practice)9 CAREY AVE
BUTLER, NJ 07405
(973) 838-1213
Dentist (General Practice)9 CAREY AVE
BUTLER, NJ 07405
(973) 838-1477
1104199462 JOANNE HWANG D.D.S.
Dentist (General Practice)9 CAREY AVE
BUTLER, NJ 07405
(973) 838-1477

Frequently Asked Questions

What is Dr. Paul Palmarozzo D.P.M. NPI number?

The NPI number assigned to this healthcare provider is 1063574929, registered as an "individual" on December 15, 2006

Where is Dr. Paul Palmarozzo D.P.M. located?

The provider is located at 9 Carey Ave Suite 300 Butler, Nj 07405 and the phone number is (973) 838-8885

Which is Dr. Paul Palmarozzo D.P.M. specialty?

The provider's speciality is Podiatrist with a focus in Foot Surgery

How many years of experience does Dr. Paul Palmarozzo D.P.M. have?

The provider has more than 37 years of experience. He graduated from New York College Of Podiatric Medicine in 1986.

What insurance does Dr. Paul Palmarozzo D.P.M. accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Dr. Paul Palmarozzo D.P.M. registered in PECOS?

Yes, as of May 11, 2023 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) and a Home Health Agency (HHA).

What are some of the services provided by Dr. Paul Palmarozzo D.P.M.?

The most common procedures or services performed by this practitioner are: Removal of tissue from 6 or more finger or toe nails, Removal of 2 to 4 thickened skin growths, Removal of tissue from 1 to 5 finger or toe nails and Removal of single thickened skin growth.

How do I update my NPI information?

The NPI record of Dr. Paul Palmarozzo D.P.M. was last updated on December 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]
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