DR. THERESA KATHERINE KRAWIEC MD
NPI 1235698085
Surgery in Worcester, MA

NPI Status: Active since March 19, 2019

Contact Information

55 LAKE AVE N
WORCESTER, MA
ZIP 01655
Phone: (508) 334-0545
Fax: (774) 443-0544

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 7
Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About THERESA KRAWIEC

This page provides the complete NPI Profile along with additional information for Theresa Krawiec, a provider established in Worcester, Massachusetts with a medical specialization in Surgery and more than 7 years of experience. She graduated from Rutgers New Jersey Medical School in 2019. The healthcare provider is registered in the NPI registry with number 1235698085 assigned on March 2019. The practitioner's primary taxonomy code is 208600000X with license number 1019404 (MA). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI: 1235698085
Provider Name: DR. THERESA KATHERINE KRAWIEC MD
Gender: Female
Entity Type: Individual
Location Address: 55 LAKE AVE N WORCESTER, MA 01655
Location Phone: (508) 334-0545
Location Fax: (774) 443-0544
Mailing Address: PO BOX 415348 BOSTON, MA 02241
Medical School Name: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduation Year: 2019
Is Sole Proprietor?: No
Enumeration Date: 03-19-2019
Last Update Date: 06-26-2024
Code Navigator

A surgeon like Theresa Krawiec treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

Location Map

Secondary Locations

4755 Ogletown Stanton Rd
Newark, DE 19718
(302) 733-1980

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Surgery
Taxonomy Code: 208600000X
Type: Allopathic & Osteopathic Physicians
License No.: 1019404
License State: MA
Taxonomy Description: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	390200000X	Student, Health Care	Student in an Organized Health Care Education/Training Program

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Theresa Krawiec is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Theresa Krawiec is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 7618202144
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20240708001921
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 for a new patient copayment and $18.3 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 01655 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $90.7
Minimum New Patient Price $58.86
Maximum New Patient Price $177.36

Average New Patient Copayment $22.67
Minimum New Patient Copayment $14.71
Maximum New Patient Copayment $44.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $73.22
Minimum Established Patient Price $19.11
Maximum Established Patient Price $144.84

Average Established Patient Copayment $18.3
Minimum Established Patient Copayment $4.77
Maximum Established Patient Copayment $36.21

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	2	3	5	6	9	8	0	8	5
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	6	5	12	9	16	0	16
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 6 + 5 + 1 + 2 + 9 + 1 + 6 + 0 + 1 + 6 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 5									5

The NPI number 1235698085 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. SARAH BETH SAXER PHARMD

Pharmacist

(Pharmacotherapy)

55 LAKE AVE N
UMASS MED CENTER DEPT OF PHARMACY
WORCESTER, MA
ZIP 01655

About THERESA KRAWIEC

Location Map

Secondary Locations

Specialty - Primary Taxonomy

Surgery

Secondary Taxonomies

Student in an Organized Health Care Education/Training Program

Insurance Plans Accepted

Anthem Blue Cross and Blue Shield

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 7618202144

PECOS Enrollment ID: I20240708001921

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for DR. THERESA KATHERINE KRAWIEC MD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions

What is Theresa Krawiec's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Theresa Krawiec accept?