RICHARD WHELAN M.D.
NPI 1063596542
Colon & Rectal Surgery in New York, NY

Active since October 24, 2006PECOS EnrolledAccepts Medicare Assignment
425 W 59TH ST, STE 7B, NEW YORK, NY 10019(212) 523-8172 Get Directions Write a Review

NPPES record last updated: October 22, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Richard Whelan M.d. NPPES

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

RICHARD WHELAN M.D. (NPI 1063596542) is an individual colon & rectal surgery provider in New York, New York, licensed in New York (162960-1) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and is a graduate of Columbia University College Of Physicians And Surgeons (1982).

NPPES Registry Identity

NPI1063596542
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameRICHARD WHELANCredential: M.D.
Location Address425 W 59TH ST, STE 7BNew York, NY 10019-8022
Mailing AddressPo Box 95000-3980Philadelphia, PA 19195-3980 · (212) 523-8172
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1982
Enumeration DateOctober 24, 2006
Last NPPES UpdateOctober 22, 2012
NPI 1063596542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License Licensed in NY · 162960-1
Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

425 W 59TH ST, New York, NY 10019

Other Identifiers 3

Medicare ID-Type Unspecified32E421NY
Medicaid01093645NY
Medicare UPINA62180NY

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

Richard Whelan M.d. 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 ID1052381845
PECOS Enrollment IDI20040729000062
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 7

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.

Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
58 services49 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
31 services30 patients
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.
27 services18 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 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.
19 services15 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.
15 services15 patients

Hospital Affiliations CMS Care Compare

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

Lenox Hill Hospital

Acute Care Hospitals · New York, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330119
Location100 East 77th StreetNew York, NY 10021 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 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
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Ostomy pouch, closed, with barrier attached, with filter (1 piece), each A4416
DME-Orthotic Devices · category DF010N
2 suppliers12 claims1,320 services$2.50 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
4 suppliers15 claims560 services$0.21 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 20

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

Internal Medicine (Endocrinology, Diabetes & Metabolism)
425 W 59TH ST, 8TH FLOOR
NEW YORK, NY 10019
Internal Medicine (Interventional Cardiology)
425 W 59TH ST, 9-C
NEW YORK, NY 10019
Internal Medicine (Cardiovascular Disease)
425 W 59TH ST, 9-C
NEW YORK, NY 10019
Obstetrics & Gynecology
425 W 59TH ST, 4B
NEW YORK, NY 10019
Internal Medicine (Cardiovascular Disease)
425 W 59TH ST
NEW YORK, NY 10019
Psychiatry & Neurology (Neurology)
425 W 59TH ST, SUITE 7C
NEW YORK, NY 10019
Surgery
425 W 59TH ST, SUITE 7A
NEW YORK, NY 10019
Physician Assistant (Medical)
425 W 59TH ST, 10TH FLOOR
NEW YORK, NY 10019

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 Richard Whelan's NPI number?

The NPI number for Richard Whelan is 1063596542. It was assigned to this individual provider in the NPPES registry on October 24, 2006.

Where is Richard Whelan located?

Richard Whelan practices at 425 W 59th St Ste 7B, New York, NY 10019. The listed phone number is (212) 523-8172.

What is Richard Whelan's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Richard Whelan enrolled in Medicare?

Yes. Richard Whelan 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 Richard Whelan affiliated with any hospitals?

According to CMS data, Richard Whelan is affiliated with Lenox Hill Hospital.

When was this NPI record last updated?

The NPPES record for Richard Whelan was last updated on October 22, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.