DR. GILES F WHALEN M.D.
NPI 1538141957
Surgery in Worcester, MA


Quality Rating: 97.02 out of 100 score

NPI Status: Active since November 20, 2005

Contact Information

119 BELMONT ST
DEPARTMENT OF SURGICAL ONCOLOGY
WORCESTER, MA
ZIP 01605
Phone: (508) 334-5202
Fax: (508) 334-5089

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  • Individual
  • Male
  • Surgery

About GILES WHALEN

This page provides the complete NPI Profile along with additional information for Giles Whalen, a provider established in Worcester, Massachusetts with a medical specialization in Surgery. The healthcare provider is registered in the NPI registry with number 1538141957 assigned on November 2005. The practitioner's primary taxonomy code is 208600000X with license number 57085 (MA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1538141957
Provider Name
DR. GILES F WHALEN M.D.
Gender
Male
Entity Type
Individual
Location Address
119 BELMONT ST DEPARTMENT OF SURGICAL ONCOLOGY WORCESTER, MA 01605
Location Phone
(508) 334-5202
Location Fax
(508) 334-5089
Mailing Address
21 WINWOOD RD SUTTON, MA 01590
Is Sole Proprietor?
No
Enumeration Date
11-20-2005
Last Update Date
07-31-2024
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A surgeon like Giles Whalen treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.

Location Map

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

Surgery

Taxonomy Code
208600000X
Type
Allopathic & Osteopathic Physicians
License No.
57085
License State
MA
Taxonomy Description
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

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
3113922MEDICAID (05)MA 
110053383AMEDICAID (05)MA 

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.

Established patient office or other outpatient visit, 10-19 minutes

This 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 20 times for 17 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 31 times for 28 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 22 times for 21 patients

Melanoma (skin cancer) excision

Melanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.

This service was performed for 1-10 patients

New patient office or other outpatient visit, 30-44 minutes

This 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 40 times for 40 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 39 times for 39 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 97.02, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 97.02 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 78.09

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Reviews for DR. GILES F WHALEN M.D.

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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 1538141957, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

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.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
3
Doubled → 6
Pos 4
8
Unchanged
Pos 5
1
Doubled → 2
Pos 6
4
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
7
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 3 → 6 1 → 2 1 → 2 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 6 + 8 + 2 + 4 + 2 + 9 + 1 + 0 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1538141957.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Specialist
119 BELMONT ST
WORCESTER, MA 01605
Internal Medicine (Cardiovascular Disease)
119 BELMONT ST
WORCESTER, MA 01605
Obstetrics & Gynecology (Reproductive Endocrinology)
119 BELMONT ST, DEPARTMENT OF OBSTETRICS & GYNECOLOGY
WORCESTER, MA 01605
Obstetrics & Gynecology (Gynecologic Oncology)
119 BELMONT ST, DEPARTMENT OF GYNECOLOGIC ONCOLOGY
WORCESTER, MA 01605
Obstetrics & Gynecology (Obstetrics)
119 BELMONT ST, DEPARTMENT OF OBSTETRICS & GYNECOLOGY
WORCESTER, MA 01605
Internal Medicine
119 BELMONT ST, DEPARTMENT OF HOSPITAL MEDICINE
WORCESTER, MA 01605
Internal Medicine (Cardiovascular Disease)
119 BELMONT ST, DEPARTMENT OF CARDIOVASCULAR MEDICINE
WORCESTER, MA 01605
Anesthesiology
119 BELMONT ST
WORCESTER, MA 01605
Anesthesiology
119 BELMONT ST
WORCESTER, MA 01605
Anesthesiology
119 BELMONT ST
WORCESTER, MA 01605
Radiology (Radiation Oncology)
119 BELMONT ST, DEPARTMENT OF RADIATION ONCOLOGY
WORCESTER, MA 01605
Surgery
119 BELMONT ST, DEPARTMENT OF GENERAL SURGERY
WORCESTER, MA 01605
Family Medicine
119 BELMONT ST, DEPARTMENT OF FAMILY HOSPITAL MEDICINE
WORCESTER, MA 01605
Psychiatry & Neurology (Neurology)
119 BELMONT ST, DEPARTMENT OF NEUROLOGY
WORCESTER, MA 01605
Internal Medicine
119 BELMONT ST, DEPARTMENT OF PALLIATIVE CARE
WORCESTER, MA 01605
Internal Medicine (Cardiovascular Disease)
119 BELMONT ST, DEPARTMENT OF CARDIOLOGY
WORCESTER, MA 01605
Internal Medicine (Hematology & Oncology)
119 BELMONT ST, DEPARTMENT OF HEMATOLOGY/ONCOLOGY
WORCESTER, MA 01605
Orthopaedic Surgery
119 BELMONT ST, DEPARTMENT OF ORTHOPEDIC SURGERY
WORCESTER, MA 01605
Psychiatry & Neurology (Neurology)
119 BELMONT ST, DEPARTMENT OF NEUROLOGY
WORCESTER, MA 01605
Pathology (Anatomic Pathology)
119 BELMONT ST, DEPARTMENT OF ANATOMIC PATHOLOGY
WORCESTER, MA 01605

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538141957, enumerated as an "individual" on November 20, 2005.

The provider is located at 119 BELMONT ST DEPARTMENT OF SURGICAL ONCOLOGY WORCESTER, MA 01605 and the phone number is (508) 334-5202.

Surgery with taxonomy code 208600000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.