DR. TIMOTHY M LOUGHRAN MD
NPI 1083659585
Internal Medicine in Danvers, MA
Active since June 18, 2006PECOS EnrolledAccepts Medicare Assignment
91.41/100
CMS Quality Rating
About Dr. Timothy M Loughran Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TIMOTHY M LOUGHRAN MD (NPI 1083659585) is an individual internal medicine provider in Danvers, Massachusetts, licensed in Massachusetts (216467) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Anna Jaques Hospital, and maintains a secondary practice location in Portsmouth.
NPPES Registry Identity
NPI1083659585
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. TIMOTHY M LOUGHRANCredential: MD
Location Address480 MAPLE ST STE 204Danvers, MA 01923-4065
Mailing Address41 Mall Rd Ste 202wBurlington, MA 01805-0002 · (781) 744-8085
Phone(978) 774-0989
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJune 18, 2006
Last NPPES UpdateSeptember 22, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2022
✔ NPI 1083659585 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MA · 216467✔ Licensed in NH · 12465
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
480 MAPLE ST STE 204, Danvers, MA 01923
Secondary Practice Location 1
Location 1155 Borthwick Ave, SUITE 202WPortsmouth, NH 03801-7156 · Phone (603) 433-8434 · Fax (603) 436-6608
Other Identifiers 1
Medicaid3084597NH
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
Dr. Timothy M Loughran Md 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 ID5991777443
PECOS Enrollment IDI20040806000429
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 14
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.
306 services149 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
99 services99 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
74 services74 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
59 services59 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.
47 services39 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
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Anna Jaques Hospital
Acute Care Hospitals · Newburyport, MAOwnershipVoluntary non-profit - Private
CMS Certification Number220029
Location25 Highland AvenueNewburyport, MA 01950 · Essex County
Emergency services Birthing friendly
Northeast Hospital Corporation
Acute Care Hospitals · Beverly, MAOwnershipVoluntary non-profit - Private
CMS Certification Number220033
Location85 Herrick StreetBeverly, MA 01915 · Essex County
Emergency services Birthing friendly
Winchester Hospital
Acute Care Hospitals · Winchester, MAOwnershipVoluntary non-profit - Private
CMS Certification Number220105
Location41 Highland AvenueWinchester, MA 01890 · Middlesex County
Emergency services Birthing friendly
Lahey Hospital & Medical Center, Burlington
Acute Care Hospitals · Burlington, MAOwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 01923 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.
91.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment ModelQuality
76.87
Promoting Interoperability
100
Improvement Activities
40
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
85%522 patients4/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
51%736 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
72%1,090 patients4/55-star benchmark: 85%
Depression Utilization of the PHQ-9 Tool
The percentage of patients age 18 and older with the diagnosis of major depression or dysthymia who have a completed PHQ-9 during each applicable 4 month period in which there was a qualifying visit
Patients 4MonthsOfEnd: 9% · 208 patients
Patients 4MonthsOfStart: 7% · 177 patients
7%215 patients
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
53%176 patients3/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
98%4,897 patients4/55-star benchmark: 100%
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.
88%5,730 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
99%693 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
17%1,871 patients1/55-star benchmark: 88%
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%1,162 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.
99%2,229 patients5/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
89%694 patients4/55-star benchmark: 90%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
66%1,491 patients4/55-star benchmark: 88%
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%2,229 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…
91%2,229 patients5/55-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%2,229 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.
Referred Medical Equipment & Supplies CMS DME claims 10
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
4 suppliers12 claims33 services$6.60 avg. paid by Medicare
Ostomy skin barrier, liquid (spray, brush, etc.), per oz A4369
DME-Orthotic Devices · category DF010N
1 supplier11 claims22 services$2.13 avg. paid by Medicare
Ostomy skin barrier, powder, per oz A4371
DME-Orthotic Devices · category DF010N
3 suppliers13 claims19 services$3.51 avg. paid by Medicare
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
3 suppliers17 claims420 services$4.69 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each A4407
DME-Orthotic Devices · category DF010N
3 suppliers15 claims420 services$8.34 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
3 suppliers15 claims420 services$3.46 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
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Timothy Loughran's NPI number?
The NPI number for Timothy Loughran is 1083659585. It was assigned to this individual provider in the NPPES registry on June 18, 2006.
Where is Timothy Loughran located?
Timothy Loughran practices at 480 Maple St Ste 204, Danvers, MA 01923. The listed phone number is (978) 774-0989.
What is Timothy Loughran's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Timothy Loughran enrolled in Medicare?
Yes. Timothy Loughran 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 Timothy Loughran affiliated with any hospitals?
According to CMS data, Timothy Loughran is affiliated with Anna Jaques Hospital, Northeast Hospital Corporation, Winchester Hospital and Lahey Hospital & Medical Center, Burlington.
When was this NPI record last updated?
The NPPES record for Timothy Loughran was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
