KEVIN S EMERICK MD
NPI 1255344545
Otolaryngology in Boston, MA
NPI Status: Active since August 15, 2006
Contact Information
243 CHARLES ST
BOSTON, MA
ZIP 02114
Phone: (617) 573-4084
- Individual
- Male
- Years of Experience 25
- Otolaryngology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KEVIN EMERICK
This page provides the complete NPI Profile along with additional information for Kevin Emerick, a provider established in Boston, Massachusetts with a medical specialization in Otolaryngology and more than 25 years of experience. He graduated from Indiana University School Of Medicine in 2001. The healthcare provider is registered in the NPI registry with number 1255344545 assigned on August 2006. The practitioner's primary taxonomy code is 207Y00000X with license number 230619 (MA). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1255344545
- Provider Name
- KEVIN S EMERICK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 243 CHARLES ST BOSTON, MA 02114
- Location Phone
- (617) 573-4084
- Mailing Address
- 243 CHARLES ST BOSTON, MA 02114
- Mailing Phone
- (617) 573-4084
- Medical School Name
- INDIANA UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2001
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-15-2006
- Last Update Date
- 09-24-2018
- Code Navigator
Location Map
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
Otolaryngology
- Taxonomy Code
- 207Y00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 230619
- License State
- MA
- Taxonomy Description
- An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - 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%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Kevin Emerick 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.
Kevin Emerick 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: 5092710939
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: I20070803000137
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Adhesive remover, wipes, any type, each (HCPCS:A4456)
1 DME suppliers used 12 Medicare Claims 600 Services Paid
Orthotic Devices
DME-Orthotic Devices (DF010N)
Skin barrier, wipes or swabs, each (HCPCS:A5120)
1 DME suppliers used 20 Medicare Claims 1100 Services Paid
DME-Orthotic Devices (DF000N)
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each (HCPCS:A7507)
1 DME suppliers used 12 Medicare Claims 690 Services Paid
DME-Orthotic Devices (DF000N)
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each (HCPCS:A7508)
1 DME suppliers used 21 Medicare Claims 720 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy or removal of deep lymph nodes of neck
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Diagnostic exam of voice box using a flexible endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 20.0 sq cm or less
Full thickness skin graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 20.0 sq cm
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less
Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less
Full thickness skin graft to scalp, arms, or legs, each additional 20.0 sq cm
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less
Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 2.1-3.0 cm
Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm
Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm
Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, more than 4.0 cm
Removal of growth of muscle of face or scalp, 2.0 cm or more
Removal of growth of saliva gland with release of facial nerve
Removal of lymph nodes, muscle, and tissue of neck
Removal of skin and tissue, 20.0 sq cm or less
Telephone medical discussion with physician, 21-30 minutes
A biopsy or removal of deep neck lymph nodes is a procedure where a small sample of tissue is taken from your neck's lymph nodes. This test helps diagnose diseases like cancer. It involves a small incision and is usually performed under anesthesia.
This service was performed 23 times for 23 patientsThis procedure involves the complex repair of a wound in areas like the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The wound size ranges from 2.6-7.5 cm. The process includes cleaning, removing damaged tissue, and stitching the wound for proper healing.
This service was performed 28 times for 28 patientsThis procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
This service was performed 15 times for 14 patientsThis 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.
This service was performed 171 times for 150 patientsThis 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.
This service was performed 500 times for 298 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 46 times for 39 patientsA full thickness skin graft involves transplanting skin from one area of the body to another. In this case, to the forehead, cheeks, chin, mouth, neck, underarms, hands, or feet. The procedure helps heal areas affected by injury or disease, covering an area of 20.0 sq cm or less.
This service was performed 12 times for 12 patientsA full-thickness skin graft involves transferring skin from one area of the body to another. This procedure is often used to treat significant skin loss due to burns, injuries, or surgery. The additional 20.0 sq cm refers to the size of the graft beyond the initial portion.
This service was performed 17 times for 11 patientsA full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.
This service was performed 17 times for 16 patientsA full-thickness skin graft involves transferring a layer of skin from one area of the body to the scalp, arms, or legs. This procedure, covering an area 20.0 sq cm or less, aids in healing wounds or areas with skin loss. It's a safe, common surgical practice.
This service was performed 27 times for 27 patientsA full thickness skin graft involves taking a layer of skin from a healthy area of your body and transplanting it to a damaged area on your scalp, arms, or legs. The graft covers an area of 20.0 sq cm and helps to promote healing.
This service was performed 44 times for 21 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 128 patientsThis 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.
This service was performed 147 times for 147 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 21 times for 21 patientsThis procedure involves preparing a specific area of your body, such as the face, scalp, neck, or extremities, for a skin graft. A skin graft is a surgical procedure where healthy skin is transferred to an area of the body that has lost skin. This preparation ensures the graft will take hold effectively.
This service was performed 11 times for 11 patientsThis procedure involves the careful removal of a cancerous growth on the face, ears, eyelids, nose, lips, or mouth that measures between 2.1 to 3.0 cm. The goal is to eliminate the cancer while preserving surrounding healthy tissue.
This service was performed 19 times for 18 patientsThis procedure involves the careful removal of a cancerous growth on the face, including areas like the ears, eyelids, nose, lips, or mouth. The size of the growth is between 3.1 and 4.0 cm. The aim is to eliminate cancer cells while preserving surrounding healthy tissue.
This service was performed 14 times for 14 patientsThis procedure involves the careful removal of a cancerous skin growth larger than 4.0 cm from the face, ears, eyelids, nose, lips, or mouth. The aim is to eliminate cancer cells while preserving surrounding healthy tissue. Local anesthesia is typically used.
This service was performed 25 times for 24 patientsThis procedure involves the surgical removal of a cancerous growth on the scalp, neck, hands, or feet that measures over 4.0 cm. It is performed under local anesthesia and may require stitches. The goal is to eliminate all cancer cells and prevent further spread.
This service was performed 32 times for 31 patientsThis procedure involves the surgical removal of a growth, 2.0 cm or larger, from the muscle of the face or scalp. The growth could be a benign or malignant tumor. The process is performed under local or general anesthesia to ensure comfort.
This service was performed 15 times for 14 patientsThis procedure involves the surgical removal of an abnormal growth in your saliva gland. During the surgery, the facial nerve, which might be affected by the growth, is carefully preserved to maintain facial functions.
This service was performed 13 times for 13 patientsThis procedure, known as a neck dissection, involves removing lymph nodes, muscle, and tissue from the neck. It's performed to treat or prevent the spread of disease, often cancer. It's a major surgery, but it can help ensure your health and recovery.
This service was performed 23 times for 22 patientsThis 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.
This service was performed 14 times for 12 patientsThis service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
This service was performed 19 times for 16 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.02 for a new patient copayment and $19.71 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 02114 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $144.11
- Minimum New Patient Price $63.72
- Maximum New Patient Price $189.86
- Average New Patient Copayment $36.02
- Minimum New Patient Copayment $15.93
- Maximum New Patient Copayment $47.46
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $78.84
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $19.71
- Minimum Established Patient Copayment $5.26
- Maximum Established Patient Copayment $38.82
* 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kevin Emerick is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTH SHORE MEDICAL CENTER - | 81 HIGHLAND AVENUE SALEM, MA 01970 | (978) 741-1215 | Acute Care Hospitals | |
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT STREET BOSTON, MA 02114 | (617) 724-9725 | Acute Care Hospitals | |
| MASSACHUSETTS EYE AND EAR INFIRMARY - | 243 CHARLES STREET BOSTON, MA 02114 | (617) 523-7900 | Acute Care Hospitals | |
| NEWTON-WELLESLEY HOSPITAL | 2014 WASHINGTON STREET NEWTON, MA 02462 | (617) 243-6000 | Acute Care Hospitals | |
| BRIGHAM AND WOMEN'S HOSPITAL | 75 FRANCIS STREET BOSTON, MA 02115 | (617) 732-5500 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1255344545, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BOSTON, MA 02114
BOSTON, MA 02114
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255344545, enumerated as an "individual" on August 15, 2006.
The provider is located at 243 CHARLES ST BOSTON, MA 02114 and the phone number is (617) 573-4084.
Otolaryngology with taxonomy code 207Y00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
Kevin Emerick is affiliated with: NORTH SHORE MEDICAL CENTER -, MASSACHUSETTS GENERAL HOSPITAL, MASSACHUSETTS EYE AND EAR INFIRMARY -, NEWTON-WELLESLEY HOSPITAL and BRIGHAM AND WOMEN'S HOSPITAL.
