1. Home
  2. Directory
  3. Massachusetts
  4. Worcester
  5. Internal Medicine
  6. NPI Profile

PAUL SEDGWICK MD
NPI 1366559460
Internal Medicine in Worcester, MA

Active since August 24, 2006PECOS EnrolledAccepts Medicare Assignment
200 LINCOLN ST, WORCESTER, MA 01605(508) 755-1222(508) 754-9479 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Paul Sedgwick Md NPPES

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

PAUL SEDGWICK MD (NPI 1366559460) is an individual internal medicine provider in Worcester, Massachusetts, licensed in Massachusetts (57340) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Massachusetts Medical School (1984).

NPPES Registry Identity

NPI1366559460
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePAUL SEDGWICKCredential: MD
Location Address200 LINCOLN STWorcester, MA 01605-2528
Mailing Address200 Lincoln StWorcester, MA 01605-2528 · (508) 755-1222 · Fax (508) 754-9479
Phone(508) 755-1222
Fax(508) 754-9479
Sole ProprietorYes
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 1984
Enumeration DateAugust 24, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1366559460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 57340
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
200 LINCOLN ST, Worcester, MA 01605
Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type UnspecifiedJ30264MA
Medicaid3100197MA
Medicare UPINF72442MA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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 Sedgwick Md 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 ID7012956998
PECOS Enrollment IDI20050429000412
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 3

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 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.
149 services61 patients
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.
144 services53 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
44 services44 patients

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220001
Location60 Hospital RoadLeominster, MA 01453 · Worcester County
Emergency services

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220019
Location100 South StreetSouthbridge, MA 01550 · Worcester County
Emergency services

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220163
Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01605 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers19 claims61 services$5.81 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
1 supplier15 claims870 services$4.39 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier15 claims900 services$0.82 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
1 supplier15 claims15 services$26.07 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH J. SAVITT, MD
Internal Medicine
200 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 755-1222
LAURIE MANTHOS, D.M.D., P.C.
Dentist (Oral and Maxillofacial Surgery)
200 LINCOLN ST, SUITE 1
WORCESTER, MA 01605
Worcester County (508) 752-2100
DR. LAURIE MANTHOS D.M.D.
Dentist (Oral and Maxillofacial Surgery)
200 LINCOLN ST, SUITE 1
WORCESTER, MA 01605
Worcester County (508) 752-2100
YVONNNE AKUSIKA MARKHAM
Counselor
200 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 753-5425
LIANNE INC
Family Medicine
200 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 755-1222
RICHARD A HAAS, MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
200 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 755-1222
MRS. JANICE C HITZHUSEN M.D.
Internal Medicine
200 LINCOLN ST, SUITE 4
WORCESTER, MA 01605
Worcester County (508) 756-0111
DR. PRABHASADANAM G SADHUJAN
Internal Medicine
200 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 755-1222

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 Sedgwick's NPI number?

The NPI number for Paul Sedgwick is 1366559460. It was assigned to this individual provider in the NPPES registry on August 24, 2006.

Where is Paul Sedgwick located?

Paul Sedgwick practices at 200 Lincoln St, Worcester, MA 01605. The listed phone number is (508) 755-1222.

What is Paul Sedgwick's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Paul Sedgwick enrolled in Medicare?

Yes. Paul Sedgwick 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 Sedgwick accept?

Health plans from Anthem Blue Cross and Blue Shield list Paul Sedgwick 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 Sedgwick affiliated with any hospitals?

According to CMS data, Paul Sedgwick is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Health - Harrington Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Paul Sedgwick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.