DONALD E PELTO DPM
NPI 1164756631
Podiatrist in Worcester, MA

Q: What is Donald Pelto's NPI number?

The NPI number for Donald Pelto is 1164756631. It was assigned to this individual provider in the NPPES registry on September 30, 2009.

Q: What is Donald Pelto's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Pelto was last updated on June 18, 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.

Active since September 30, 2009PECOS EnrolledAccepts Medicare Assignment

88.95/100

CMS Quality Rating

299 LINCOLN ST, SUITE 202, WORCESTER, MA 01605(508) 757-4003(508) 755-7592 Get Directions Write a Review

NPPES record last updated: June 18, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Donald E Pelto Dpm NPPES

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

DONALD E PELTO DPM (NPI 1164756631) is an individual podiatrist in Worcester, Massachusetts, licensed in Massachusetts (2343) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1164756631

Entity TypeIndividualMale

Primary Taxonomy213E00000X

Provider Legal NameDONALD E PELTOCredential: DPM

Location Address299 LINCOLN ST, SUITE 202Worcester, MA 01605-3646

Mailing Address299 Lincoln St Ste 202Worcester, MA 01605-3646 · (508) 757-4003 · Fax (508) 755-7592

Phone(508) 757-4003

Fax(508) 755-7592

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateSeptember 30, 2009

Last NPPES UpdateJune 18, 2020

NPPES CertifiedJune 18, 2020

✔ NPI 1164756631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in MA · 2343

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

299 LINCOLN ST, Worcester, MA 01605

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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

Donald E Pelto Dpm 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 ID9931248648

PECOS Enrollment IDI20091209000094

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 27

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 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.

451 services310 patients

Removal of fingernails or toenails, 1-5 nails 11720

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

304 services152 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

301 services192 patients

Trimming of fingernails or toenails 11719

Trimming of fingernails or toenails is a simple procedure for maintaining hygiene and preventing nail-related issues. It involves cutting the nails straight across, then smoothing any sharp edges with a file. Regular nail care can help prevent infections and discomfort.

273 services125 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.

201 services201 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

191 services93 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

182 services77 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

130 services43 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

130 services43 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.

108 services83 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

64 services28 patients

Removal of noncancer thickened skin growth, more than 4 growths 11057

This procedure involves the removal of more than four noncancerous, thickened skin growths. It's a simple process where a healthcare professional uses a specialized tool to carefully remove these growths, promoting healthier skin.

56 services24 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

51 services31 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

46 services35 patients

X-ray of foot, 2 views 73620

An X-ray of the foot, 2 views, is a quick, painless test that produces images of the bones and structures inside your foot. Two different angles are used to provide a comprehensive view. This helps doctors diagnose fractures, infections, or other abnormalities.

42 services28 patients

Complete ultrasound study of arm and leg arteries 93923

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

42 services42 patients

X-ray of heel, minimum of 2 views 73650

An X-ray of the heel, minimum of 2 views, is a diagnostic procedure where safe radiation beams capture images of your heel from at least two different angles. This helps in identifying issues such as fractures, bone spurs, or arthritis. You'll remain still while the images are taken.

41 services28 patients

Limited ultrasound scan of joint or other extremity structure except blood vessels 76882

A limited ultrasound scan of a joint or other extremity structure lacking blood vessels is a non-invasive procedure that uses sound waves to create images of the inside of your body. This helps in diagnosing and monitoring conditions related to your joints or other similar structures.

41 services37 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.

41 services41 patients

X-ray of ankle, 2 views 73600

An X-ray of the ankle, 2 views, is a quick, painless test that produces images of the bones and joints in your ankle. Two different angles are used to provide a more complete picture. It helps detect fractures, sprains, arthritis, or other abnormalities. It's safe and typically takes only a few minutes.

38 services30 patients

Permanent removal fingernail or toenail 11750

Permanent removal of a fingernail or toenail, also known as avulsion, is a procedure performed to treat nail infections or severe ingrown nails. The nail is carefully removed under local anesthesia. After removal, a chemical is applied to prevent nail regrowth, ensuring the issue does not recur.

23 services15 patients

Simple or single drainage of skin abscess 10060

A simple or single drainage of skin abscess is a procedure to remove pus from a skin infection. A small cut is made on the abscess, the pus is drained out, and the area is cleaned. This helps to reduce pain, speed up recovery, and prevent the spread of infection.

22 services21 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

19 services14 patients

Aspiration and/or injection of fluid from medium joint 20605

This procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.

19 services14 patients

Simple separation of fingernail or toenail from nail bed, first nail 11730

This procedure involves the gentle removal of the first nail from its bed, often due to injury or infection. It's performed under local anesthesia to minimize discomfort. The nail will gradually regrow over time.

16 services16 patients

Aspiration and/or injection of fluid from small joint using ultrasound guidance 20604

This procedure involves using ultrasound to accurately locate a small joint. A needle is then carefully inserted to remove fluid (aspiration) or inject medication. This can help diagnose or treat joint issues. It's generally safe and minimally invasive.

13 services11 patients

Closed treatment of broken bone in forefoot or midfoot 28470

Closed treatment of a broken bone in your forefoot or midfoot is a non-surgical procedure. Your doctor will realign the broken bones without making an incision. You may need to wear a cast or special shoe to help the bones heal properly.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01605 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

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

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.

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.

88.95/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

79.92

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Advance Care Plan

97%769 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

41%158 patients2/55-star benchmark: 87%

Controlling High Blood Pressure

1%78 patients1/55-star benchmark: 91%

Diabetes: Eye Exam

0%172 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%172 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

100%2,814 patients5/55-star benchmark: 100%

e-Prescribing

98%426 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%738 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

27%1,724 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%2,560 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 12% · 778 patients

12%778 patients

Provide Patients Electronic Access to Their Health Information

81%1,341 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

84%284 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 782 patients

Patients totalRate: 0% · 782 patients

0%782 patients5/55-star benchmark: 100%

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 3

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

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

2 suppliers15 claims30 services$61.54 avg. paid by Medicare

For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each A5514

DME-Orthotic Devices · category DF000N

2 suppliers11 claims66 services$37.54 avg. paid by Medicare

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361

DME-Orthotic Devices · category DF003N

1 supplier16 claims16 services$275.94 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 13

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

JAMES M SHENKO MD PC

Specialist

299 LINCOLN ST
WORCESTER, MA 01605

Worcester County (508) 852-2001

DR. NEIL J FELDMAN DPM

Podiatrist (Foot Surgery)

299 LINCOLN ST, SUITE 202
WORCESTER, MA 01605

Worcester County (508) 757-4003

JAMES M SHENKO, MD PC

Plastic Surgery (Surgery of the Hand)

299 LINCOLN ST, SUITE 201
WORCESTER, MA 01605

Worcester County (508) 852-2001

DR. JASJIT SINGH GILL D.M.D

Dentist (Oral and Maxillofacial Surgery)

299 LINCOLN ST, SUITE 204
WORCESTER, MA 01605

Worcester County (508) 852-0021

J LEITAO-PINA MD PC

Clinic/Center (Primary Care)

299 LINCOLN ST, SUITE 201
WORCESTER, MA 01605

Worcester County (508) 853-8700

KATHLEEN O'BRIEN LMHC

Counselor (Mental Health)

299 LINCOLN ST
WORCESTER, MA 01605

Worcester County (774) 206-1125

ROBERT R GRONDIN DPM

Podiatrist (Foot Surgery)

299 LINCOLN ST, SUITE 202
WORCESTER, MA 01605

Worcester County (508) 757-4003

DR. CHRISTOPHER KEVIN CLANCY D.M.D

Dentist (Oral and Maxillofacial Surgery)

299 LINCOLN ST, SUITE 204
WORCESTER, MA 01605

Worcester County (508) 852-0021

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 Donald Pelto's NPI number?

The NPI number for Donald Pelto is 1164756631. It was assigned to this individual provider in the NPPES registry on September 30, 2009.

Where is Donald Pelto located?

Donald Pelto practices at 299 Lincoln St Suite 202, Worcester, MA 01605. The listed phone number is (508) 757-4003.

What is Donald Pelto's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Donald Pelto enrolled in Medicare?

Yes. Donald Pelto 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.

What insurance does Donald Pelto accept?

Health plans from Anthem Blue Cross and Blue Shield list Donald Pelto 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.

When was this NPI record last updated?

The NPPES record for Donald Pelto was last updated on June 18, 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.