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DR. MIGUEL L. ZIALCITA M.D.
NPI 1396782108
Psychiatry & Neurology - Neurology in Worcester, MA

Active since June 01, 2006PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
67 BELMONT ST, WORCESTER, MA 01605(508) 334-6641(508) 334-9036 Get Directions Write a Review

NPPES record last updated: March 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Miguel L. Zialcita M.d. NPPES

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

DR. MIGUEL L. ZIALCITA M.D. (NPI 1396782108) is an individual neurology provider in Worcester, Massachusetts, licensed in Massachusetts (226369) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (1995).

NPPES Registry Identity

NPI1396782108
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. MIGUEL L. ZIALCITACredential: M.D.
Location Address67 BELMONT STWorcester, MA 01605-2657
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Phone(508) 334-6641
Fax(508) 334-9036
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1995
Enumeration DateJune 1, 2006
Last NPPES UpdateMarch 25, 2022
NPPES CertifiedMarch 25, 2022
✔ NPI 1396782108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in MA · 226369✔ Licensed in GA · 048019
Definition
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.
67 BELMONT ST, Worcester, MA 01605
Open in Google Maps ↗

Other Identifiers 8

Medicaid2132290MA
Other783884MA · Aetna
OtherAA68645MA · Harvard Pilgrim
Other466805MA · Tufts
Medicaid000856402AGA
OtherJ41642MA · Bcbs
Other000000034431MA · Bmc Healthnet
Other1396782108MA · Neighborhood Health

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

Dr. Miguel L. Zialcita M.d. 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 ID1355376609
PECOS Enrollment IDI20060410000167
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 8

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 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.
69 services56 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
51 services51 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
45 services45 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This 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.
33 services31 patients
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.
25 services22 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
24 services18 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.09
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

KAITLYN OLDEWURTEL DO
Colon & Rectal Surgery
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-8195
MARK WEBSTER MAXFIELD M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-5826
MIRRET EL-HAGRASSY
Psychiatry & Neurology (Neurology)
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-6641
DR. GEOFFREY M GRAEBER M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
67 BELMONT ST, DIVISION OF THORACIC SURGERY
WORCESTER, MA 01605
Worcester County (508) 334-8996
DR. FRANCIS MICHAEL HUTTINGER MD
Psychiatry & Neurology (Neurology)
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-6641
MS. JANET A MCDADE NP
Nurse Practitioner
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-8195
MR. MIN SHICK AHN MD
Otolaryngology
67 BELMONT ST, STE 103
WORCESTER, MA 01605
Worcester County (508) 755-8623
CARLOS FAIREN ORO MD
Surgery
67 BELMONT ST
WORCESTER, MA 01605
Worcester County (508) 334-8195

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 Miguel Zialcita's NPI number?

The NPI number for Miguel Zialcita is 1396782108. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Miguel Zialcita located?

Miguel Zialcita practices at 67 Belmont St, Worcester, MA 01605. The listed phone number is (508) 334-6641.

What is Miguel Zialcita's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Miguel Zialcita enrolled in Medicare?

Yes. Miguel Zialcita 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 Miguel Zialcita accept?

Health plans from Anthem Blue Cross and Blue Shield list Miguel Zialcita 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 Miguel Zialcita affiliated with any hospitals?

According to CMS data, Miguel Zialcita 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 Miguel Zialcita was last updated on March 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.