MARY GORSKI PA-C, MA
NPI 1336179076
Physician Assistant in West Springfield, MA
NPI Status: Active since July 04, 2006
Contact Information
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
Phone: (413) 592-1980
Fax: (413) 439-0096
- Individual
- Female
- Years of Experience 30
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MARY GORSKI
This page provides the complete NPI Profile along with additional information for Mary Gorski, a primary care provider established in West Springfield, Massachusetts with a medical specialization in Physician Assistant and more than 30 years of experience. The healthcare provider is registered in the NPI registry with number 1336179076 assigned on July 2006. The practitioner's primary taxonomy code is 363A00000X with license number 842 (MA). The provider is registered as an individual and her NPI record was last updated 18 years ago.
- NPI
- 1336179076
- Provider Name
- MARY GORSKI PA-C, MA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1132 WESTFIELD ST WEST SPRINGFIELD, MA 01089
- Location Phone
- (413) 592-1980
- Location Fax
- (413) 439-0096
- Mailing Address
- 32B N FARMS RD HAYDENVILLE, MA 01039
- Mailing Phone
- (413) 592-1980
- Medical School Name
- OTHER
- Graduation Year
- 1996
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-04-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A primary care provider (PCP) like Mary Gorski sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 842
- License State
- MA
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
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 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
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 |
|---|---|---|---|
| 83-00771 | OTHER (01) | MA | EVERCARE |
| AP0380 | MEDICARE ID-TYPE UNSPECIFIED (04) | MA |
Medicare Participation & PECOS Enrollment Status
Mary Gorski 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.
Mary Gorski 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: 1759280324
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: I20040102000314
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.
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 1,187 times for 275 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 158 times for 94 patientsA follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
This service was performed 15 times for 15 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 109 times for 108 patientsPhysician 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 01089 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.
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 |
|---|---|---|
| Adult Major Depressive Disorder (MDD): Suicide Risk Assessment | 12% | 26 |
| Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder (MDD) with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified | ||
| Documentation of Current Medications in the Medical Record | 16% | 1188 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 21% | 236 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Influenza Immunization | 6% | 286 |
| Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
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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 | 3 | 3 | 6 | 1 | 7 | 9 | 0 | 7 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 2 | 7 | 18 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 2 + 7 + 1 + 8 + 0 + 1 + 4 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1336179076 is valid because the calculated check digit 6 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. JAMES S THOMPSON MD
Psychiatry & Neurology
(Psychiatry)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
DR. KERRY L BLOOMINGDALE M.D.
Psychiatry & Neurology
(Psychiatry)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
KAREN MOZZER LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
BEVERLY REED LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
JO-ANNE GAUGHAN-CABRAL LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
SUSAN FAGAN MORAN LMHC
Counselor
(Mental Health)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
LARRY R CANN LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
LISA AVANZATO-USHKURNIS LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
GORDON G LOHNES LMHC
Counselor
(Mental Health)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
JOAN W HILDRETH LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
NORA OTERO-NEMIROVSKY LMHC
Counselor
(Mental Health)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
IRIS KINGSBURY LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
SEAN HARRIS LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
DEBRA SCHRAFFT LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
MARY ALGIER M.S.
Social Worker
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
JENNIFER SAARI PA
Physician Assistant
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
SHERRY HIGHTOWER-SIDNEY LMHC
Counselor
(Mental Health)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
KRISTINE DUSTIN LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
MRS. STACEY L ROSSANO LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
CINDY OPPER LICSW
Social Worker
(Clinical)
1132 WESTFIELD ST
WEST SPRINGFIELD, MA
ZIP 01089
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336179076, enumerated as an "individual" on July 04, 2006.
The provider is located at 1132 WESTFIELD ST WEST SPRINGFIELD, MA 01089 and the phone number is (413) 592-1980.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
