MICHELLE JANE MAILLOUX PT, DPT
NPI 1316547201
Physical Medicine & Rehabilitation - Sports Medicine in Worcester, MA
NPI Status: Active since October 29, 2020
Contact Information
484 MAIN ST STE 600
WORCESTER, MA
ZIP 01608
Phone: (800) 244-2756
- Individual
- Female
- Years of Experience 6
- Physical Medicine & Rehabilitation
- Sports Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
About MICHELLE MAILLOUX
This page provides the complete NPI Profile along with additional information for Michelle Mailloux, a provider established in Worcester, Massachusetts with a medical specialization in Physical Medicine & Rehabilitation, focusing in sports medicine and more than 6 years of experience. The healthcare provider is registered in the NPI registry with number 1316547201 assigned on October 2020. The practitioner's primary taxonomy code is 2081S0010X with license number 25187 (MA). The provider is registered as an individual and her NPI record was last updated 6 years ago.
- NPI
- 1316547201
- Provider Name
- MICHELLE JANE MAILLOUX PT, DPT
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 484 MAIN ST STE 600 WORCESTER, MA 01608
- Location Phone
- (800) 244-2756
- Mailing Address
- 41 BRIAR AVE LOWELL, MA 01852
- Mailing Phone
- (978) 761-5322
- Medical School Name
- OTHER
- Graduation Year
- 2020
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-29-2020
- Last Update Date
- 10-29-2020
- Code Navigator
Location Map
Secondary Locations
- 41 Briar Ave
Lowell, MA 01852
(978) 761-5322
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
Physical Medicine & Rehabilitation Sports Medicine
- Taxonomy Code
- 2081S0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25187
- License State
- MA
- Taxonomy Description
- A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Gold 2300 Legacy - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Bronze Plan Legacy - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Gold Plan Legacy - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Regence Standard Silver Plan Legacy - EPO
- Silver 6500 Individual Connect - EPO
- Silver 6500 Legacy - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michelle Mailloux 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.
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.
PECOS PAC ID: 9638610892
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: I20240916002715
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.
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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 1316547201, we treat the final digit (1) 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
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 49 is 50. 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.
WORCESTER, MA 01608
WORCESTER, MA 01608
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316547201, enumerated as an "individual" on October 29, 2020.
The provider is located at 484 MAIN ST STE 600 WORCESTER, MA 01608 and the phone number is (800) 244-2756.
Physical Medicine & Rehabilitation with taxonomy code 2081S0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.. Please consult your insurance carrier or call the provider to verify.