MONICA KAPOOR MD
NPI 1407012818
Emergency Medicine in Worcester, MA

Active since August 05, 2008PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(508) 421-1400(508) 421-1490 Get Directions Write a Review

NPPES record last updated: November 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 22, 2020, Jul 17, 2019 (2 updates tracked since 2019).

About Monica Kapoor Md NPPES

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

MONICA KAPOOR MD (NPI 1407012818) is an individual emergency medicine provider in Worcester, Massachusetts, licensed in Massachusetts (278715) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1407012818
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameMONICA KAPOORCredential: MD
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Fax(508) 421-1490
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2006
Enumeration DateAugust 5, 2008
Last NPPES UpdateNovember 22, 20202 updates tracked since enumeration
NPPES CertifiedNovember 22, 2020
NPI 1407012818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in MA · 278715
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
55 LAKE AVE N, Worcester, MA 01655

Secondary Practice Locations 3

Location 1201 Highland StClinton, MA 01510-1037 · Phone (508) 421-1400 · Fax (508) 421-1490
Location 2157 Union StMarlborough, MA 01752-1228 · Phone (508) 421-1400 · Fax (508) 421-1490
Location 3119 Belmont StWorcester, MA 01605-2903 · Phone (508) 421-1400 · Fax (508) 421-1490

Other Identifiers 1

Medicaid110150066AMA

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

Monica Kapoor 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 ID5698812857
PECOS Enrollment IDI20190726001765
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 10

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
112 services111 patients
Ultrasound of heart, follow-up 93308
A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.
101 services100 patients
Ultrasound scan of chest 76604
An ultrasound scan of the chest is a non-invasive imaging procedure that uses sound waves to create pictures of the structures within your chest, such as your heart and lungs. It's a safe, painless method that helps doctors diagnose and monitor various conditions.
96 services96 patients
Limited ultrasound scan of abdomen 76705
A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.
71 services71 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
68 services68 patients
Critical care, first 30-74 minutes 99291
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.
35 services35 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 Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220049
Location157 Union StreetMarlborough, MA 01752 · Middlesex 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 01655 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
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.

Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655

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 Monica Kapoor's NPI number?

The NPI number for Monica Kapoor is 1407012818. It was assigned to this individual provider in the NPPES registry on August 5, 2008.

Where is Monica Kapoor located?

Monica Kapoor practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 421-1400.

What is Monica Kapoor's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Monica Kapoor enrolled in Medicare?

Yes. Monica Kapoor 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.

Is Monica Kapoor affiliated with any hospitals?

According to CMS data, Monica Kapoor is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Healthcare-Marlborough Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Monica Kapoor was last updated on November 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.