JOHANNA A. HELENIUS M.D.
NPI 1336403930
Psychiatry & Neurology - Neurology in Burlington, MA
Quality Rating: 90.7 out of 100 score
NPI Status: Active since June 28, 2012
Contact Information
41 MALL RD
BURLINGTON, MA
ZIP 01805
Phone: (781) 744-8630
Fax: (781) 744-5581
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 27
- Psychiatry & Neurology
- Neurology
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JOHANNA HELENIUS
This page provides the complete NPI Profile along with additional information for Johanna Helenius, a provider established in Burlington, Massachusetts with a medical specialization in Psychiatry & Neurology, focusing in neurology and more than 27 years of experience. The healthcare provider is registered in the NPI registry with number 1336403930 assigned on June 2012. The practitioner's primary taxonomy code is 2084N0400X with license number 265972 (MA). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1336403930
- Provider Name
- JOHANNA A. HELENIUS M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 41 MALL RD BURLINGTON, MA 01805
- Location Phone
- (781) 744-8630
- Location Fax
- (781) 744-5581
- Mailing Address
- 41 MALL RD BURLINGTON, MA 01805
- Mailing Phone
- (781) 744-8630
- Mailing Fax
- (781) 744-5581
- Medical School Name
- OTHER
- Graduation Year
- 1999
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-28-2012
- Last Update Date
- 07-21-2022
- 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
Psychiatry & Neurology Neurology
- Taxonomy Code
- 2084N0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 265972
- License State
- MA
- Taxonomy Description
- A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | 252917 (MA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- 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 Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Johanna Helenius 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.
Johanna Helenius 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: 1355648585
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: I20170707000831
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-Other DME (DE001N)
Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)
1 DME suppliers used 20 Medicare Claims 20 Services Paid
DME-Other DME (DE001N)
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Headgear used with positive airway pressure device (HCPCS:A7035)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
DME-Other DME (DE001N)
Filter, disposable, used with positive airway pressure device (HCPCS:A7038)
1 DME suppliers used 15 Medicare Claims 70 Services Paid
DME-Other DME (DE001N)
Continuous positive airway pressure (cpap) device (HCPCS:E0601)
1 DME suppliers used 51 Medicare Claims 51 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.
Critical care, first 30-74 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, more than 30 minutes
Initial hospital inpatient care per day, typically 70 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 85 times for 73 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 66 times for 55 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 239 times for 181 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 173 times for 68 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 52 times for 52 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 43 times for 43 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 14 times for 14 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 53 times for 53 patientsThis service involves a consulting physician assessing your health condition through a phone or internet consultation lasting over 30 minutes. The physician will provide a verbal explanation and a written report of the findings, helping you understand your health status better.
This service was performed 19 times for 19 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $36.02 for a new patient copayment and $27.79 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 01805 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 99214
- Average Established Patient Price $111.18
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $27.79
- 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.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.7, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 90.7 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 76.53
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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. Johanna Helenius is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTHEAST HOSPITAL CORPORATION | 85 HERRICK STREET BEVERLY, MA 01915 | (978) 922-3000 | Acute Care Hospitals | |
| WINCHESTER HOSPITAL | 41 HIGHLAND AVENUE WINCHESTER, MA 01890 | (781) 729-9000 | Acute Care Hospitals | |
| LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON | 41 & 45 MALL ROAD BURLINGTON, MA 01803 | (781) 744-5100 | Acute Care Hospitals |
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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 | 4 | 0 | 3 | 9 | 3 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 8 | 0 | 6 | 9 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 8 + 0 + 6 + 9 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1336403930 is valid because the calculated check digit 0 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.
KAREN ORINO CRNA
Nurse Anesthetist, Certified Registered
41 MALL RD
BURLINGTON, MA
ZIP 01805
MANUEL J MERINO MD
Urology
41 MALL RD
LAHEY CLINIC
BURLINGTON, MA
ZIP 01805
DR. BENJAMIN ARI TILLINGER MD
Internal Medicine
(Cardiovascular Disease)
41 MALL RD
CARDIOVASCULAR MEDICINE
BURLINGTON, MA
ZIP 01805
ANTHONY P WEINER MD
Psychiatry & Neurology
(Psychiatry)
41 MALL RD
BURLINGTON, MA
ZIP 01805
DR. LATA CHANDI THATAI MD
Internal Medicine
(Hematology & Oncology)
41 MALL RD
LAHEY CLINIC
BURLINGTON, MA
ZIP 01805
DR. LESLIE PAULETTE SHAFF MD
Anesthesiology
41 MALL RD
BURLINGTON, MA
ZIP 01805
DR. DILIP NATARAJ MD
Internal Medicine
(Pulmonary Disease)
41 MALL RD
LAHEY CLINIC, INC.
BURLINGTON, MA
ZIP 01805
HEATHER L TORRE PA-C
Physician Assistant
41 MALL RD
BURLINGTON, MA
ZIP 01805
TIMOTHY F. KAISER MD
Family Medicine
(Geriatric Medicine)
41 MALL RD
LAHEY CLINIC, DEPARTMENT OF GERIATRICS
BURLINGTON, MA
ZIP 01805
DR. ARTUR ZEMBOWICZ MD, PH D
Pathology
(Dermatopathology)
41 MALL RD
LAHEY CLINIC
BURLINGTON, MA
ZIP 01805
BRAD P MANUEL PAC
Physician Assistant
(Medical)
41 MALL RD
BURLINGTON, MA
ZIP 01805
MS. JEAN E FISCHER PA-C
Physician Assistant
41 MALL RD
LAHEY CLLINIC MEDICAL CENTER-CARDIOTHORACIC SURGERY
BURLINGTON, MA
ZIP 01805
DR. ADAM JAMES VERNADAKIS M.D.
Plastic Surgery
41 MALL RD
LAHEY CLINIC, INC. - PLASTIC SURGERY
BURLINGTON, MA
ZIP 01805
SUSAN M HURLEY NP
Nurse Practitioner
41 MALL RD
BURLINGTON, MA
ZIP 01805
THOMAS D. WOLD DO
Internal Medicine
(Pulmonary Disease)
41 MALL RD
BURLINGTON, MA
ZIP 01805
JASON R GEE MD
Urology
41 MALL RD
BURLINGTON, MA
ZIP 01805
ARTHUR P MOURTZINOS M.D.
Urology
41 MALL RD
BURLINGTON, MA
ZIP 01805
THOMAS MCLAUGHLIN PA
Physician Assistant
41 MALL RD
LAHEY CLINIC, INC.
BURLINGTON, MA
ZIP 01805
YAMIN DOU M.D.
Nuclear Medicine
(Nuclear Imaging & Therapy)
41 MALL RD
LAHEY CLINIC
BURLINGTON, MA
ZIP 01805
YEVGENIY ARSHANSKIY M.D.
Radiology
(Diagnostic Radiology)
41 MALL RD
LAHEY CLINIC MEDICAL CENTER
BURLINGTON, MA
ZIP 01805
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336403930, enumerated as an "individual" on June 28, 2012.
The provider is located at 41 MALL RD BURLINGTON, MA 01805 and the phone number is (781) 744-8630.
Psychiatry & Neurology with taxonomy code 2084N0400X and a focus in Neurology.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld and Anthem Blue. Please consult your insurance carrier or call the provider to verify.
Johanna Helenius is affiliated with: NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL and LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON.
