HEATHER C. SIENEL PA-C
NPI 1528316544
Physician Assistant in Charlton, MA
NPI Status: Active since August 23, 2012
Contact Information
10 N MAIN ST
CHARLTON, MA
ZIP 01507
Phone: (508) 248-8105
Fax: (508) 248-8106
- Individual
- Female
- Years of Experience 17
- Physician Assistant
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About HEATHER SIENEL
This page provides the complete NPI Profile along with additional information for Heather Sienel, a primary care provider established in Charlton, Massachusetts with a medical specialization in Physician Assistant and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1528316544 assigned on August 2012. The practitioner's primary taxonomy code is 363A00000X with license number PA4478 (MA). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1528316544
- Provider Name
- HEATHER C. SIENEL PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 10 N MAIN ST CHARLTON, MA 01507
- Location Phone
- (508) 248-8105
- Location Fax
- (508) 248-8106
- Mailing Address
- 5 SWORD ST AUBURN, MA 01501
- Medical School Name
- OTHER
- Graduation Year
- 2009
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-23-2012
- Last Update Date
- 04-09-2019
- Code Navigator
A primary care provider (PCP) like Heather Sienel sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Secondary Locations
- 123 Summer St
Worcester, MA 01608
(508) 363-5000
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
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA4478
- License State
- MA
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - 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%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110112302A | MEDICAID (05) | MA |
Medicare Participation & PECOS Enrollment Status
Heather Sienel 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.
Heather Sienel 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: 1456501121
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: I20121016000351
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Tape, waterproof, per 18 square inches (HCPCS:A4452)
3 DME suppliers used 40 Medicare Claims 3270 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Collagen dressing, sterile, size 16 sq. in. or less, each (HCPCS:A6021)
3 DME suppliers used 52 Medicare Claims 771 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing (HCPCS:A6196)
3 DME suppliers used 144 Medicare Claims 4762 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing (HCPCS:A6197)
2 DME suppliers used 44 Medicare Claims 1049 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6209)
1 DME suppliers used 11 Medicare Claims 138 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6212)
4 DME suppliers used 49 Medicare Claims 682 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing (HCPCS:A6219)
2 DME suppliers used 24 Medicare Claims 882 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing (HCPCS:A6222)
2 DME suppliers used 24 Medicare Claims 832 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing (HCPCS:A6223)
2 DME suppliers used 16 Medicare Claims 435 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard (HCPCS:A6446)
2 DME suppliers used 50 Medicare Claims 6126 Services Paid
DME-Medical/Surgical Supplies (DA023N)
Tubular dressing with or without elastic, any width, per linear yard (HCPCS:A6457)
3 DME suppliers used 21 Medicare Claims 104 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Application of chemical to stop tissue regrowth in wound
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
New patient office or other outpatient visit, 30-44 minutes
Removal of skin and tissue, 20.0 sq cm or less
Removal of skin and tissue, each additional 20.0 sq cm or less
This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.
This service was performed 16 times for 16 patientsThis is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
This service was performed 79 times for 67 patientsThis 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.
This service was performed 774 times for 125 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 25 times for 20 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 55 times for 55 patientsThis procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
This service was performed 348 times for 86 patientsThis procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.
This service was performed 125 times for 24 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 for a new patient copayment and $18.3 for an established patient copayment.
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 01507 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.7
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.67
- Minimum New Patient Copayment $14.71
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $73.22
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $18.3
- Minimum Established Patient Copayment $4.77
- Maximum Established Patient Copayment $36.21
* 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
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. Heather Sienel is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL | 100 SOUTH STREET SOUTHBRIDGE, MA 01550 | (508) 765-9771 | Acute Care Hospitals | |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS | 55 LAKE AVENUE NORTH WORCESTER, MA 01655 | (508) 334-1000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1528316544, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528316544, enumerated as an "individual" on August 23, 2012.
The provider is located at 10 N MAIN ST CHARLTON, MA 01507 and the phone number is (508) 248-8105.
Physician Assistant with taxonomy code 363A00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
Heather Sienel is affiliated with: UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL and UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS.
