DR. PAUL JEROME PALAFOX CUSTODIO M.D.
NPI 1093997280
Internal Medicine - Endocrinology, Diabetes & Metabolism in New Kensington, PA
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
6Medicare enrollment records show Paul Jerome Custodio reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New Kensington, PA 15068
- Reassigned Medicare billing, Pennsylvania enrollment
- 2,881 clinicians in this Medicare group
Rootstown, OH 44272
- Reassigned Medicare billing, Ohio enrollment
- 655 clinicians in this Medicare group
Bemus Point, NY 14712
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Chautauqua Medical Practice PC
- 154 clinicians in this Medicare group
Williamsport, PA 17701
- Reassigned Medicare billing, Pennsylvania enrollment
- 24 clinicians in this Medicare group
Collegeville, PA 19426
- Reassigned Medicare billing, Pennsylvania enrollment
- 192 clinicians in this Medicare group
Philadelphia, PA 19131
- Reassigned Medicare billing, Pennsylvania enrollment
- 1,205 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Summa Health System
Acute Care Hospitals · Akron, OHEvangelical Community Hospital
Acute Care Hospitals · Lewisburg, PAUpmc Williamsport
Acute Care Hospitals · Williamsport, PAEinstein Medical Center Montgomery
Acute Care Hospitals · East Norriton, PAUpmc Muncy
Critical Access Hospitals · Muncy, PAPhysician 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.
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.
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.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW KENSINGTON, PA 15068
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.
Which organizations bill Medicare for Paul Jerome Custodio's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Paul Jerome Custodio reassigns Medicare benefits to 6 organizations: Allegheny Clinic (New Kensington, PA), Summa Physicians LLC (Rootstown, OH), Chautauqua Medical Practice, P.C. (Bemus Point, NY), Susquehanna Physician Services (Williamsport, PA), Fornance Physician Services, Inc (Collegeville, PA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Paul Jerome Custodio's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Paul Jerome Custodio accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Paul Jerome Custodio as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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, Einstein Medical Center Montgomery 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. Paul Jerome Palafox Custodio, M.D. · NPI 1093997280
Endocrinology, Diabetes & Metabolism physician in New Kensington, Pennsylvania. Individual provider, active in the CMS NPPES registry since November 29, 2007.
## Identity
- **NPI:** 1093997280 (Entity type: Individual)
- **Enumerated:** November 29, 2007
- **Primary specialty:** Internal Medicine - Endocrinology, Diabetes & Metabolism · taxonomy 207RE0101X
- **State license:** MD456308 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 356 FREEPORT ST, New Kensington, PA 15068-6071
- **Phone:** (724) 367-2400 · **Fax:** (724) 367-2401
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Allegheny Clinic (NPI 1063848117, New Kensington, PA); Summa Physicians LLC (NPI 1154728061, Rootstown, OH); Chautauqua Medical Practice, P.C. (NPI 1922181767, Bemus Point, NY); Susquehanna Physician Services (NPI 1184652133, Williamsport, PA); Fornance Physician Services, Inc (NPI 1023439825, Collegeville, PA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** October 8, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1093997280) · Data from the CMS NPPES public registry.