DR. PAUL JEROME PALAFOX CUSTODIO M.D.
NPI 1093997280
Internal Medicine - Endocrinology, Diabetes & Metabolism in New Kensington, PA

Active since November 29, 2007PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
356 FREEPORT ST, NEW KENSINGTON, PA 15068(724) 367-2400(724) 367-2401 Get Directions Write a Review

NPPES record last updated: October 8, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 8, 2020, Jul 31, 2019, Mar 17, 2018 and 4 more (7 updates tracked since 2016).

About Dr. Paul Jerome Palafox Custodio M.d. NPPES

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

DR. PAUL JEROME PALAFOX CUSTODIO M.D. (NPI 1093997280) is an individual endocrinology, diabetes & metabolism provider in New Kensington, Pennsylvania, licensed in Pennsylvania (MD456308) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS, is affiliated with Summa Health System, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1093997280
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. PAUL JEROME PALAFOX CUSTODIOCredential: M.D.
Location Address356 FREEPORT STNew Kensington, PA 15068-6071
Mailing Address356 Freeport StNew Kensington, PA 15068-6071 · (724) 367-2400 · Fax (724) 367-2401
Fax(724) 367-2401
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateNovember 29, 2007
Last NPPES UpdateOctober 8, 20207 updates tracked since enumeration
NPPES CertifiedOctober 8, 2020
NPI 1093997280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License Licensed in PA · MD456308
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
356 FREEPORT ST, New Kensington, PA 15068

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. Paul Jerome Palafox Custodio 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 ID8123306164
PECOS Enrollment IDI20161026002469, I20241204001798
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 3

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.

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
28 services28 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
25 services20 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
22 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Summa Health System

Acute Care Hospitals · Akron, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360020
Location525 East Market StreetAkron, OH 44309 · Summit County
Emergency services Birthing friendly

Evangelical Community Hospital

Acute Care Hospitals · Lewisburg, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390013
LocationOne Hospital DriveLewisburg, PA 17837 · Union County
Emergency services Birthing friendly

Upmc Williamsport

Acute Care Hospitals · Williamsport, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390045
Location700 High StreetWilliamsport, PA 17701 · Lycoming County
Emergency services Birthing friendly

Upmc Muncy

Critical Access Hospitals · Muncy, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391301
Location215 East Water StreetMuncy, PA 17756 · Lycoming County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15068 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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
22 suppliers68 claims194 services$5.52 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers22 claims31 services$0.95 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
9 suppliers107 claims107 services$189.92 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 11

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

Family Medicine
356 FREEPORT ST, 1ST FLOOR
NEW KENSINGTON, PA 15068
Nurse Practitioner (Family)
356 FREEPORT ST
NEW KENSINGTON, PA 15068
Internal Medicine (Endocrinology, Diabetes & Metabolism)
356 FREEPORT ST
NEW KENSINGTON, PA 15068
Dietitian, Registered
356 FREEPORT ST
NEW KENSINGTON, PA 15068
Internal Medicine
356 FREEPORT ST, SUITE 205
NEW KENSINGTON, PA 15068
Dietitian, Registered
356 FREEPORT ST
NEW KENSINGTON, PA 15068
Family Medicine
356 FREEPORT ST
NEW KENSINGTON, PA 15068
Non-Pharmacy Dispensing Site
356 FREEPORT ST, 205
NEW KENSINGTON, PA 15068

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 Jerome Custodio's NPI number?

The NPI number for Paul Jerome Custodio is 1093997280. It was assigned to this individual provider in the NPPES registry on November 29, 2007.

Where is Paul Jerome Custodio located?

Paul Jerome Custodio practices at 356 Freeport St, New Kensington, PA 15068. The listed phone number is (724) 367-2400.

What is Paul Jerome Custodio's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Paul Jerome Custodio enrolled in Medicare?

Yes. Paul Jerome Custodio 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 Jerome Custodio affiliated with any hospitals?

According to CMS data, Paul Jerome Custodio is affiliated with Summa Health System, Evangelical Community Hospital, Upmc Williamsport and Upmc Muncy.

When was this NPI record last updated?

The NPPES record for Paul Jerome Custodio was last updated on October 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.