MICHAEL JOHN HALL MD
NPI 1194286617
Emergency Medicine in Worcester, MA

Active since March 27, 2019PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(508) 421-1400(508) 421-1490 Get Directions Write a Review

NPPES record last updated: April 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Michael John Hall Md NPPES

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

MICHAEL JOHN HALL MD (NPI 1194286617) is an individual emergency medicine provider in Worcester, Massachusetts, licensed in Massachusetts (291201) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Vermont College Of Medicine (2019).

NPPES Registry Identity

NPI1194286617
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameMICHAEL JOHN HALLCredential: MD
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Fax(508) 421-1490
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 2019
Enumeration DateMarch 27, 2019
Last NPPES UpdateApril 28, 2023
NPPES CertifiedApril 28, 2023
NPI 1194286617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in MA · 291201
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedEmergency Medicine · Emergency Medical ServicesTaxonomy 207PE0004X · License 291201 (MA)
55 LAKE AVE N, Worcester, MA 01655

Other Identifiers 1

Medicaid110153346AMA

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

Michael John Hall 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 ID8628304748
PECOS Enrollment IDI20220322003127
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 10

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
168 services167 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
94 services93 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
46 services29 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
25 services25 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
24 services12 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
23 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220049
Location157 Union StreetMarlborough, MA 01752 · Middlesex County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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
$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.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Internal Medicine (Cardiovascular Disease)
55 LAKE AVE N, CARDIOLOGY
WORCESTER, MA 01655
Psychiatry & Neurology (Psychiatry)
55 LAKE AVE N
WORCESTER, MA 01655
Genetic Counselor, MS
55 LAKE AVE N, S1-710
WORCESTER, MA 01655
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Rheumatology)
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N, DEPARTMENT OF GENERAL MEDICINE
WORCESTER, MA 01655
Pathology (Anatomic Pathology)
55 LAKE AVE N, DEPARTMENT OF PATHOLOGY
WORCESTER, MA 01655

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 Michael Hall's NPI number?

The NPI number for Michael Hall is 1194286617. It was assigned to this individual provider in the NPPES registry on March 27, 2019.

Where is Michael Hall located?

Michael Hall practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 421-1400.

What is Michael Hall's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Michael Hall enrolled in Medicare?

Yes. Michael Hall 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 Michael Hall affiliated with any hospitals?

According to CMS data, Michael Hall is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Healthcare-Marlborough Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Michael Hall was last updated on April 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.