MR. MICHAEL A TOMEO MD
NPI 1326046830
Dermatology in Doylestown, PA
NPI Status: Active since July 08, 2005
Contact Information
610 FARM LANE
DOYLESTOWN, PA
ZIP 18901
Phone: (215) 728-2754
Fax: (215) 214-3992
- Individual
- Male
- Years of Experience 39
- Dermatology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MICHAEL TOMEO
This page provides the complete NPI Profile along with additional information for Michael Tomeo, a provider established in Doylestown, Pennsylvania with a medical specialization in Dermatology and more than 39 years of experience. He graduated from Temple University School Of Medicine in 1987. The healthcare provider is registered in the NPI registry with number 1326046830 assigned on July 2005. The practitioner's primary taxonomy code is 207N00000X with license number MD031507E (PA). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1326046830
- Provider Name
- MR. MICHAEL A TOMEO MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 610 FARM LANE DOYLESTOWN, PA 18901
- Location Phone
- (215) 728-2754
- Location Fax
- (215) 214-3992
- Mailing Address
- 3500 N BROAD ST # 1A PHILADELPHIA, PA 19140
- Mailing Phone
- (215) 707-2433
- Medical School Name
- TEMPLE UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1987
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-08-2005
- Last Update Date
- 11-20-2024
- Code Navigator
A dermatologist like Michael Tomeo is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
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
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD031507E
- License State
- PA
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
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
- NH Local Choice HMO Bronze 8000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Gold 1400 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local Choice HMO Silver 5000 + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Bronze 7500 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Gold 2000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- NH Local HMO Silver 6000 Standard + $0 Rx list + $0 Virtual Urgent Care - HMO
- my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
- my Blue Access Select PPO Bronze 3800 - PPO
- my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Bronze 9200 - PPO
- my Blue Access Select PPO Gold 0 - PPO
- my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Gold 1700 HSA - PPO
- my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0057026000 | OTHER (01) | PA | KEYSTONE HEALTHPLAN EAST |
| 57566 | OTHER (01) | PA | AETNA |
Medicare Participation & PECOS Enrollment Status
Michael Tomeo 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.
Michael Tomeo 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: 4486696093
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: I20190410000013, I20250624000477
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
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 of related skin growth, first growth
Destruction of precancer skin growth, 1 growth
Destruction of precancer skin growth, 2-14 growths
Destruction of skin growth, 1-14 growths
Established patient office or other outpatient visit, 20-29 minutes
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 15-29 minutes
New patient office or other outpatient visit, 30-44 minutes
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
This service was performed 44 times for 39 patients"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
This service was performed 164 times for 95 patientsThis procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
This service was performed 787 times for 79 patients"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
This service was performed 72 times for 52 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 150 times for 96 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 1-10 patientsThis service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
This service was performed 77 times for 77 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.17 for a new patient copayment and $18.61 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 18901 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $92.69
- Minimum New Patient Price $59.88
- Maximum New Patient Price $180.99
- Average New Patient Copayment $23.17
- Minimum New Patient Copayment $14.97
- Maximum New Patient Copayment $45.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.47
- Minimum Established Patient Price $19.3
- Maximum Established Patient Price $147.29
- Average Established Patient Copayment $18.61
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $36.82
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Regular training in care coordination | Yes | N/A |
| Implementation of regular care coordination training. | ||
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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 1326046830, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326046830, enumerated as an "individual" on July 08, 2005.
The provider is located at 610 FARM LANE DOYLESTOWN, PA 18901 and the phone number is (215) 728-2754.
Dermatology with taxonomy code 207N00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Harvard Pilgrim. Please consult your insurance carrier or call the provider to verify.
