JOSEPH SARCONA M.D.
NPI 1386030237
Urology in Springfield, MA
NPI Status: Active since April 07, 2015
Contact Information
100 WASON AVE STE 120
SPRINGFIELD, MA
ZIP 01107
Phone: (413) 241-2100
- Individual
- Male
- Years of Experience 3
- Urology
- PECOS Enrolled
- Accepts Medicare Approved Payment
About JOSEPH SARCONA
Joseph Sarcona is a provider established in Springfield, Massachusetts and his medical specialization is Urology with more than 3 years of experience. The healthcare provider is registered in the NPI registry with number 1386030237 assigned on April 2015. The practitioner's primary taxonomy code is 208800000X with license number 287564 (MA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1386030237
- Provider Name
- JOSEPH SARCONA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 100 WASON AVE STE 120 SPRINGFIELD, MA 01107
- Location Phone
- (413) 241-2100
- Mailing Address
- 100 WASON AVE STE 120 SPRINGFIELD, MA 01107
- Mailing Phone
- (413) 241-2100
- Medical School Name
- OTHER
- Graduation Year
- 2021
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-07-2015
- Last Update Date
- 08-02-2021
- Code Navigator
Joseph Sarcona 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.
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.07 for a new patient copayment and $19.15 for an established patient copayment.
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
Urology
- Taxonomy Code
- 208800000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 287564
- License State
- MA
- Taxonomy Description
- A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Location Map
Secondary Locations
- 1294 Ware St
Palmer, MA 01069
(413) 241-2100
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Anthem Blue Cross and Blue Shield
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9450 - 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%/4725 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/8000 - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/8000 WH - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4725 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%/3000 - 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 3200/20%/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
- Anthem Silver Access Blue New England HMO 4000/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
PECOS Enrollment and Medicare Participation Status
Joseph Sarcona 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: 3971849787
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: I20210901000543
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
Physician Visit Costs
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 01107 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.28
- Minimum New Patient Price $61.32
- Maximum New Patient Price $185.12
- Average New Patient Copayment $35.07
- Minimum New Patient Copayment $15.33
- Maximum New Patient Copayment $46.28
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.6
- Minimum Established Patient Price $19.31
- Maximum Established Patient Price $151.47
- Average Established Patient Copayment $19.15
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $37.86
* 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.
Hospital Affiliations
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. Joseph Sarcona is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| BAYSTATE WING HOSPITAL | 40 WRIGHT STREET PALMER, MA 1069 | (413) 283-7651 | Acute Care Hospitals | |
| BAYSTATE MEDICAL CENTER | 759 CHESTNUT STREET SPRINGFIELD, MA 1199 | (413) 794-0000 | 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 | 8 | 6 | 0 | 3 | 0 | 2 | 3 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 16 | 6 | 0 | 3 | 0 | 2 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 6 + 6 + 0 + 3 + 0 + 2 + 6 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1386030237 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1306810924 | DANIELLE L BEAULIEU NP Individual | Nurse Practitioner (Acute Care) | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1235772922 | SHARON RENEE BROWN FNP Individual | Nurse Practitioner (Family) | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1245426253 | MRS. MARIANGELA MERCED PA-C Individual | Physician Assistant | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1306464375 | AMBER WHITEHILL DNP, FNP-BC Individual | Nurse Practitioner (Family) | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1194362632 | KEVIN ANTHONY PELLETIER PA-C Individual | Physician Assistant (Medical) | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1124665534 | MRS. TATIANA PARKER PA-C Individual | Physician Assistant | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1356791875 | DR. AARON JOSEPH BERKENWALD M.D. Individual | Urology | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 272-4427 |
| 1427491919 | MICHAEL E ZAVASKI MD Individual | Urology | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
| 1255025268 | KAITLIN E DEMPSEY PA-C Individual | Physician Assistant | 100 WASON AVE STE 120 SPRINGFIELD, MA 01107 (413) 241-2100 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386030237, enumerated in the NPI registry as an "individual" on April 07, 2015
The provider is located at 100 Wason Ave Ste 120 Springfield, Ma 01107 and the phone number is (413) 241-2100
The provider's speciality is Urology with taxonomy code 208800000X
The provider has more than 3 years of experience.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $140.28 with an average copayment of $35.07 for new patient appointments. Established patients should expect a typical charge of $76.6 and an average copayment of 19.15. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): BAYSTATE WING HOSPITAL and BAYSTATE MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on April 07, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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