THOMAS M VALLONE DO
NPI 1194793513
Internal Medicine - Gastroenterology in Dartmouth, MA
Active since March 10, 2006PECOS Enrolled
About Thomas M Vallone Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THOMAS M VALLONE DO (NPI 1194793513) is an individual gastroenterology provider in Dartmouth, Massachusetts, licensed in Massachusetts (210679) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Anne's Hospital, and maintains a secondary practice location in North Dartmouth.
NPPES Registry Identity
NPI1194793513
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameTHOMAS M VALLONECredential: DO
Location Address535 FAUNCE CORNER RDDartmouth, MA 02747-1242
Mailing Address535 Faunce Corner RdDartmouth, MA 02747-1242 · (508) 996-3991
Phone(508) 996-3991
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2001
Enumeration DateMarch 10, 2006
Last NPPES UpdateApril 25, 2023
NPPES CertifiedApril 25, 2023
✔ NPI 1194793513 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in MA · 210679
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
535 FAUNCE CORNER RD, Dartmouth, MA 02747
Secondary Practice Location 1
Location 1535 Faunce Corner RoadNorth Dartmouth, MA 02747 · Phone (508) 996-3991
Other Identifiers 1
Medicaid2040841MA
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 (PECOS)
Thomas M Vallone Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
PECOS PAC ID6204806490
PECOS Enrollment IDI20040727000369
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 16
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.
324 services249 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
216 services216 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.
89 services89 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
83 services82 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
66 services46 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
46 services29 patients
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Saint Anne's Hospital
Acute Care Hospitals · Fall River, MAOwnershipProprietary
CMS Certification Number220020
Location795 Middle StreetFall River, MA 02721 · Bristol County
Emergency services
St Elizabeth's Medical Center
Acute Care Hospitals · Brighton, MAOwnershipProprietary
CMS Certification Number220036
Location736 Cambridge StreetBrighton, MA 02135 · Suffolk County
Emergency services Birthing friendly
Southcoast Hospitals Group
Acute Care Hospitals · Fall River, MAOwnershipVoluntary non-profit - Private
CMS Certification Number220074
Location363 Highland AvenueFall River, MA 02720 · Bristol County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02747 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.
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
66%251 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
95%611 patients5/55-star benchmark: 85%
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.
100%1,512 patients5/55-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.
98%3,068 patients4/55-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
57%366 patients3/55-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…
78%1,918 patients4/55-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.
100%613 patients5/55-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.
92%1,134 patients4/55-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
70%366 patients4/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
74%1,115 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 312 patients
Patients tobacco: 27% · 37 patients
88%311 patients4/55-star benchmark: 98%
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…
80%1,134 patients4/55-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…
78%1,134 patients4/55-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.
31%1,134 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.
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.
Prosthetic/Orthotic Supplier
535 FAUNCE CORNER RD, SUITE 201
N DARTMOUTH, MA 02747
N DARTMOUTH, MA 02747
Internal Medicine (Cardiovascular Disease)
535 FAUNCE CORNER RD
DARTMOUTH, MA 02747
DARTMOUTH, MA 02747
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 Thomas Vallone's NPI number?
The NPI number for Thomas Vallone is 1194793513. It was assigned to this individual provider in the NPPES registry on March 10, 2006.
Where is Thomas Vallone located?
Thomas Vallone practices at 535 Faunce Corner Rd, Dartmouth, MA 02747. The listed phone number is (508) 996-3991.
What is Thomas Vallone's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Thomas Vallone enrolled in Medicare?
Yes. Thomas Vallone is registered in the Medicare PECOS enrollment system.
What insurance does Thomas Vallone accept?
Health plans from Anthem Blue Cross and Blue Shield list Thomas Vallone 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 Thomas Vallone affiliated with any hospitals?
According to CMS data, Thomas Vallone is affiliated with Saint Anne's Hospital, St Elizabeth's Medical Center and Southcoast Hospitals Group.
When was this NPI record last updated?
The NPPES record for Thomas Vallone was last updated on April 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.
