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ERIN KATE DOOLEY MD/MPH
NPI 1215199542
Family Medicine in Gardner, MA

Active since June 27, 2008PECOS EnrolledAccepts Medicare Assignment
250 GREEN ST, GARDNER, MA 01440(978) 630-6330(978) 630-6338 Get Directions Write a Review

NPPES record last updated: October 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2020, Sep 25, 2018, Jun 28, 2018 and 3 more (6 updates tracked since 2017).

About Erin Kate Dooley Md/mph NPPES

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

ERIN KATE DOOLEY MD/MPH (NPI 1215199542) is an individual family medicine provider in Gardner, Massachusetts, licensed in Massachusetts (282266) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Eastern Virginia Medical School (2008).

NPPES Registry Identity

NPI1215199542
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameERIN KATE DOOLEYCredential: MD/MPH
Location Address250 GREEN STGardner, MA 01440-1396
Mailing Address250 Green StGardner, MA 01440-1396 · (978) 630-6330 · Fax (978) 630-6338
Phone(978) 630-6330
Fax(978) 630-6338
Sole ProprietorNo
Medical School CMSEastern Virginia Medical SchoolGraduated 2008
Enumeration DateJune 27, 2008
Last NPPES UpdateOctober 24, 20246 updates tracked since enumeration
NPPES CertifiedOctober 24, 2024
✔ NPI 1215199542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in MA · 282266✔ Licensed in TN · 47038✔ Licensed in TX · R2085
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedObstetrics & Gynecology · ObstetricsTaxonomy 207VX0000X · License 47038 (TN)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 0116020547 (VA)
250 GREEN ST, Gardner, MA 01440
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Other Identifiers 1

Medicaid3722548-01TX

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

Erin Kate Dooley Md/mph 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 ID5193902328
PECOS Enrollment IDI20200415001627
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 7

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.
45 services37 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.
38 services30 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.
30 services30 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.
23 services20 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
19 services19 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
19 services19 patients

Hospital Affiliations CMS Care Compare 4

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

Heywood Hospital

Acute Care Hospitals · Gardner, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220095
Location242 Green StreetGardner, MA 01440 · Worcester County
Emergency services Birthing friendly

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

Athol Memorial Hospital

Critical Access Hospitals · Athol, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number221303
Location2033 Main StreetAthol, MA 01331 · Worcester County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01440 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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
53%94 patients3/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
21%61 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
38%155 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
20%71 patients1/55-star benchmark: 100%
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.
69%1,712 patients1/55-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.
96%2,691 patients4/55-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…
33%441 patients2/55-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.
86%291 patients2/55-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.
79%1,036 patients4/55-star benchmark: 97%
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…
99%1,036 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…
36%1,036 patients2/55-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.
45%1,036 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.

MICHELE C. PARKER M.D.
Family Medicine
250 GREEN ST
GARDNER, MA 01440
Worcester County (978) 669-0199
BARBARA J. WALKER RNNP
Nurse Practitioner
250 GREEN ST
GARDNER, MA 01440
Worcester County (978) 632-6445
AYAZ TARIQ MALIK M.D.
Internal Medicine (Gastroenterology)
250 GREEN ST, STE 212
GARDNER, MA 01440
Worcester County (978) 669-5522
JOHN M. SKRZYPCZAK M.D.
Emergency Medicine
250 GREEN ST
GARDNER, MA 01440
Worcester County (978) 630-6280
MELISSA KRISTEN CAPOTOSTO NP
Nurse Practitioner (Women's Health)
250 GREEN ST, SUITE 200
GARDNER, MA 01440
Worcester County (978) 632-6880
MERCY FAMILY PRACTICE PC
Family Medicine
250 GREEN ST, SUITE 200
GARDNER, MA 01440
Worcester County (978) 632-6445
JOHN WORDEN M.D.
Family Medicine
250 GREEN ST
GARDNER, MA 01440
Worcester County (978) 630-6445
TRICIA VORDERSTRASSE MD PC
Family Medicine
250 GREEN ST, SUITE 1 06
GARDNER, MA 01440
Worcester County (978) 249-1791

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 Erin Kate Dooley's NPI number?

The NPI number for Erin Kate Dooley is 1215199542. It was assigned to this individual provider in the NPPES registry on June 27, 2008.

Where is Erin Kate Dooley located?

Erin Kate Dooley practices at 250 Green St, Gardner, MA 01440. The listed phone number is (978) 630-6330.

What is Erin Kate Dooley's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Erin Kate Dooley enrolled in Medicare?

Yes. Erin Kate Dooley 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 Erin Kate Dooley accept?

Health plans from Anthem Blue Cross and Blue Shield list Erin Kate Dooley 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 Erin Kate Dooley affiliated with any hospitals?

According to CMS data, Erin Kate Dooley is affiliated with Umass Memorial Healthalliance Hospitals, Heywood Hospital, Umass Memorial Medical Center/University Campus and Athol Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Erin Kate Dooley was last updated on October 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.