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PAUL DURA M.D.
NPI 1326039363
Internal Medicine - Rheumatology in Binghamton, NY

Active since October 31, 2005PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
161 RIVERSIDE DR, SUITE 302, BINGHAMTON, NY 13905(607) 798-1842(607) 729-0147 Get Directions Write a Review

NPPES record last updated: February 28, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Paul Dura M.d. NPPES

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

PAUL DURA M.D. (NPI 1326039363) is an individual rheumatology provider in Binghamton, New York, licensed in New York (1766651) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (1987).

NPPES Registry Identity

NPI1326039363
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NamePAUL DURACredential: M.D.
Location Address161 RIVERSIDE DR, SUITE 302Binghamton, NY 13905-4176
Mailing Address161 Riverside Dr, Suite 302Binghamton, NY 13905-4176 · (607) 798-1842 · Fax (607) 729-0147
Phone(607) 798-1842
Fax(607) 729-0147
Sole ProprietorNo
Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 1987
Enumeration DateOctober 31, 2005
Last NPPES UpdateFebruary 28, 2008
✔ NPI 1326039363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses✔ Licensed in NY · 1766651✔ Licensed in PA · MD047446L
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
161 RIVERSIDE DR, Binghamton, NY 13905
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Other Identifiers 3

Medicaid01516370NY
Medicare UPINF24213NY
Medicare PIN55105CNY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Paul Dura M.d. 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 ID1951495969
PECOS Enrollment IDI20101115000725
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 4

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.
315 services220 patients
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.
118 services106 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.
24 services24 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This 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.
18 services16 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330011
Location169 Riverside DriveBinghamton, NY 13905 · Broome County
Emergency services Birthing friendly

United Health Services Hospitals, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330394
Location10-42 Mitchell AvenueBinghamton, NY 13903 · Broome County
Emergency services Birthing friendly

Delaware Valley Hospital, Inc

Critical Access Hospitals · Walton, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number331312
Location1 Titus PlaceWalton, NY 13856 · Delaware County
Emergency services

Endless Mountains Health Systems

Critical Access Hospitals · Montrose, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number391306
Location100 Hospital DriveMontrose, PA 18801 · Susquehanna County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13905 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.57
Promoting Interoperability95
Improvement Activities40
Cost64.87

Reported Quality Measures

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%1,697 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.
88%935 patients4/55-star benchmark: 100%
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…
3%37 patients1/55-star benchmark: 96%
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%2,483 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.
23%1,811 patients1/55-star benchmark: 99%
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…
53%1,811 patients3/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have an assessment and classification of disease prognosis at least once within 12 months
100%275 patients5/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Functional Status Assessment
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) for whom a functional status assessment was performed at least once within 12 months
100%259 patients5/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Glucocorticoid Management
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have been assessed for glucocorticoid use and, for those on prolonged doses of prednisone >= 10 mg daily (or equivalent) with improvement or no change in disease…
100%278 patients5/55-star benchmark: 100%
Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity
Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have an assessment and classification of disease activity within 12 months
100%278 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
100%222 patients5/55-star benchmark: 97%
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…
2%1,811 patients1/55-star benchmark: 59%
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.

DR. THOMAS PARSLEY MD
Internal Medicine
161 RIVERSIDE DR, SUITE 306
BINGHAMTON, NY 13905
Broome County (607) 798-6700
BINGHAMTON PLASTIC SURGERY, PLLC
Specialist
161 RIVERSIDE DR, SUITE 106
BINGHAMTON, NY 13905
Broome County (607) 729-0101
SANDY NASR MD
Internal Medicine (Rheumatology)
161 RIVERSIDE DR
BINGHAMTON, NY 13905
Broome County (607) 798-1842
MARK A DREHER DDS MD PC
Dentist
161 RIVERSIDE DR, SUITE 201
BINGHAMTON, NY 13905
Broome County (607) 748-7169
DR. DAVID C DREYFUSS M.D.
Surgery
161 RIVERSIDE DR, SUITE 105
BINGHAMTON, NY 13905
Broome County (607) 770-9471
CELESTE R KEEFE C.N.M.
Advanced Practice Midwife
161 RIVERSIDE DR, SUITE 109
BINGHAMTON, NY 13905
Broome County (607) 770-7074
JEROME C COHEN, MD, PC
Internal Medicine (Gastroenterology)
161 RIVERSIDE DR, SUITE 210
BINGHAMTON, NY 13905
Broome County (607) 770-1155
LINDA S DICKEY R.N.C.N.P.
Nurse Practitioner (Obstetrics & Gynecology)
161 RIVERSIDE DR, SUITE 109
BINGHAMTON, NY 13905
Broome County (607) 770-7074

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 Paul Dura's NPI number?

The NPI number for Paul Dura is 1326039363. It was assigned to this individual provider in the NPPES registry on October 31, 2005.

Where is Paul Dura located?

Paul Dura practices at 161 Riverside Dr Suite 302, Binghamton, NY 13905. The listed phone number is (607) 798-1842.

What is Paul Dura's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Paul Dura enrolled in Medicare?

Yes. Paul Dura 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 Paul Dura accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Paul Dura 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 Paul Dura affiliated with any hospitals?

According to CMS data, Paul Dura is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, United Health Services Hospitals, Inc, Delaware Valley Hospital, Inc and Endless Mountains Health Systems.

When was this NPI record last updated?

The NPPES record for Paul Dura was last updated on February 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.