MANISH TANDON MD NPI 1417021437

Internal Medicine (Gastroenterology) in Somerville, MA

NPI 1417021437 Individual Male Years of Experience 28 Internal Medicine Gastroenterology PECOS Enrolled Accepts Medicare Approved Payment

NPI Profile for MANISH TANDON MD

Manish Tandon is an internal medicine provider established in Somerville, Massachusetts and his medical specialization is internal medicine (gastroenterology) with more than 28 years of experience. The NPI number of Manish Tandon is 1417021437 and was assigned on November 2006. The practitioner's primary taxonomy code is 207RG0100X with license number 155573 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.

An internist like Manish Tandon Md is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Manish Tandon 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.

Manish Tandon is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with St Elizabeth's Medical Center.

The typical physician office visit costs for Medicare beneficiaries in this area are: $37.51 for a new patient copayment and $29.15 for an established patient copayment.

NPI

1417021437

Provider Name MANISH TANDON MD
Provider Location Address230 HIGHLAND AVE MEDICAL SPECIALTIES SOMERVILLE, MA 02143
Provider Mailing Address230 HIGHLAND AVE MEDICAL SPECIALTIES SOMERVILLE, MA 02143
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1995
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date11-20-2006
Last Update Date11-15-2007


Primary Taxonomy

Taxonomy Code207RG0100X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGastroenterology
License No.155573
License StateMA
Taxonomy DescriptionAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Business Address

MANISH TANDON MD
230 HIGHLAND AVE
MEDICAL SPECIALTIES
SOMERVILLE, MA
ZIP 02143
Phone: (617) 665-1552

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Mailing Address

MANISH TANDON MD
230 HIGHLAND AVE
MEDICAL SPECIALTIES
SOMERVILLE, MA
ZIP 02143
Phone: (617) 665-1552



PECOS Enrollment and Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID8426041302
PECOS Enrollment IDI20040406001287
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 02143 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$66.28 $197.76 $150.04
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$16.57 $49.44 $37.51
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$21.28 $162.14 $116.6
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$5.32 $40.53 $29.15

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 65Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 62Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 25Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)
  • 19Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 17Diagnostic examination of large bowel using an endoscope (HCPCS:45378)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare 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. Manish Tandon is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
ST ELIZABETH'S MEDICAL CENTER736 CAMBRIDGE STREET
BRIGHTON, MA 2135
(617) 789-3000Acute Care Hospitals220036

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
J24432OTHER (01)MABCBS MA
0186619MEDICAID (05)MA
SX3705MEDICARE PIN (08)MA
G90468MEDICARE UPIN (02)

NPI Validation Check Digit Calculation


The following table explains step by step the 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.
1417021437
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
242702246
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 2 + 7 + 0 + 2 + 2 + 4 + 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 = 77

The NPI number 1417021437 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1760481501DR. MICHAEL CLARENCE PAYNE M.D., M.P.H.
Individual
Internal Medicine (Gastroenterology)230 HIGHLAND AVE SOMERVILLE HOSPITAL / THE CAMBRIDGE HEALTH ALLIANCE
SOMERVILLE, MA 02143
(617) 665-1000
1659352748DR. LJILJANA GRKOVICH MD
Individual
Anesthesiology230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 666-4400
1336111020DR. LOU ANN BRUNO-MURTHA D.O.
Individual
Internal Medicine (Infectious Disease)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4780
1760430755DR. MICHAEL HERCULES THEODOULOU D.P.M.
Individual
Podiatrist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 665-1000
1164476503 INGO H STUBBE MD
Individual
Internal Medicine230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4920
1154498889 RALPH H UPCHURCH MD
Individual
Emergency Medicine230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4707
1225181910 SARAH BANSEN APRN
Individual
Nurse Practitioner (Obstetrics & Gynecology)230 HIGHLAND AVE WOMEN'S HEALTH CENTER
SOMERVILLE, MA 02143
(617) 591-4800
1538212089 KAREN LEFKOWITZ APRN
Individual
Nurse Practitioner230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-6300
1538212071 EVELYN NEIMAN APRN
Individual
Nurse Practitioner230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4800
1366651465 BARBARA J KOPPEL LICSW
Individual
Social Worker (Clinical)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 491-4786
1174732119 EMILY J SPEAGLE LICSW
Individual
Social Worker (Clinical)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4484
1376753848DR. XIA THAI PHARM.D.
Individual
Pharmacist (Pharmacotherapy)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4192
1306040290MRS. AUNKSIKA ANN SLAYTON OTR.L
Individual
Occupational Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1861696866MS. AMYBETH LYNCH PT
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4266
1811191711MRS. SELENA CHANA KUTIN P.T
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4240
1922202852MR. REID FUJIMORI DPT, MSPT
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1790980282MISS JENNIFER ANN PURDY COTAL
Individual
Occupational Therapy Assistant230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1588869481MRS. NICOLE PATRICIA STEWART MS, OTR L
Individual
Occupational Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4500
1265638209 MARLA DRISCOLL RN
Individual
Registered Nurse230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4350
1487850392 ELAINE CATALOGNA RN
Individual
Registered Nurse230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4350

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Manish Tandon Md is registered as an entity type code: 1. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.