MICHAEL S. STAUDER MD
NPI 1558383588
Internal Medicine - Cardiovascular Disease in Gardner, MA


Quality Rating: 90.62 out of 100 score

NPI Status: Active since July 25, 2006

Contact Information

250 GREEN ST
GARDNER, MA
ZIP 01440
Phone: (978) 630-5020
Fax: (978) 630-5029

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  • Individual
  • Male
  • Years of Experience 25
  • Internal Medicine
  • Cardiovascular Disease
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About MICHAEL STAUDER

This page provides the complete NPI Profile along with additional information for Michael Stauder, an internist established in Gardner, Massachusetts with a medical specialization in Internal Medicine, focusing in cardiovascular disease and more than 25 years of experience. He graduated from Loyola University Of Chicago, Stritch School Of Medicine in 2001. The healthcare provider is registered in the NPI registry with number 1558383588 assigned on July 2006. The practitioner's primary taxonomy code is 207RC0000X with license number 223390 (MA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1558383588
Provider Name
MICHAEL S. STAUDER MD
Gender
Male
Entity Type
Individual
Location Address
250 GREEN ST GARDNER, MA 01440
Location Phone
(978) 630-5020
Location Fax
(978) 630-5029
Mailing Address
250 GREEN ST GARDNER, MA 01440
Mailing Phone
(978) 630-5020
Mailing Fax
(978) 630-5029
Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduation Year
2001
Is Sole Proprietor?
No
Enumeration Date
07-25-2006
Last Update Date
04-05-2021
Code Navigator

An internist like Michael Stauder 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.

Location Map

Secondary Locations

  • 55 Lake Ave N
    Worcester, MA 01655
    (978) 630-5020

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

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
License No.
223390
License State
MA
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

223390 (MA)

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 5000/10%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
  • Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
  • Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - 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%/5500 RxD - HMO
  • Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
  • Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
  • Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
  • Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
  • Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
  • Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Michael Stauder 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.

Michael Stauder 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: 4284730946

    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: I20070426000473

    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

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.

Electrocardiogram (ecg) 2-day continuous with review by health care professional

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

This service was performed 12 times for 12 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

This service was performed 19 times for 19 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 116 times for 105 patients

Established patient office or other outpatient visit, 40-54 minutes

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.

This service was performed 22 times for 22 patients

Evaluation of cardiac rhythm monitor system, remote up to 30 days

This procedure involves remotely monitoring your heart rhythm for up to 30 days. A small device will record your heart's activity, which can be accessed by your healthcare team. This aids in diagnosing any irregularities or issues with your heart function.

This service was performed 149 times for 29 patients

Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days

This service involves remotely monitoring your heart and blood vessel implant system for up to 30 days. Using advanced technology, healthcare professionals can track the device's performance and your health status, ensuring the system is working optimally for your needs.

This service was performed 30 times for 12 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days

This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.

This service was performed 89 times for 37 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.

This service was performed 45 times for 19 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

This service was performed 99 times for 97 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

This service was performed 99 times for 97 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 63 times for 59 patients

Insertion of heart rhythm monitor under skin

The insertion of a heart rhythm monitor under the skin is a procedure to track your heart's activity. A small device is placed under your skin, recording your heart's rhythms continuously. This helps identify irregular heartbeats or conditions, aiding in your treatment.

This service was performed 14 times for 14 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 19 times for 19 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

This service was performed 70 times for 70 patients

Programming of dual lead pacemaker system

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

This service was performed 23 times for 23 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 728 times for 589 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 178 times for 178 patients

Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report

This procedure involves using ultrasound technology to create images of your heart while you rest, exercise, or undergo drug-induced stress. An ECG continuously monitors your heart's electrical activity. It helps doctors assess heart health and function.

This service was performed 14 times for 14 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $33.61 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 01440 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $134.47
  • Minimum New Patient Price $58.86
  • Maximum New Patient Price $177.36
  • Average New Patient Copayment $33.61
  • 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.

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 90.62, 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 provider also has detailed performance information the following quality measures: .

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: 90.62 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: 80.1

    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: 74.87

    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.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Documentation of Current Medications in the Medical Record 67% 1644
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 20% 809
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 31% 466
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 74% 31
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 37% 727
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 36% 726

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. Michael Stauder is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HEYWOOD HOSPITAL242 GREEN STREET
GARDNER, MA 01440
(978) 632-3420Acute Care Hospitals
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS55 LAKE AVENUE NORTH
WORCESTER, MA 01655
(508) 334-1000Acute Care Hospitals
ST VINCENT HOSPITAL123 SUMMER STREET
WORCESTER, MA 01608
(508) 363-5000Acute Care Hospitals
ATHOL MEMORIAL HOSPITAL2033 MAIN STREET
ATHOL, MA 01331
(978) 249-3511Critical Access Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step 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.
1558383588
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25108686516
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 0 + 8 + 6 + 8 + 6 + 5 + 1 + 6 + 24 = 72
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 72 = 88

The NPI number 1558383588 is valid because the calculated check digit 8 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.

DR. FRANCIS ANTHONY GAROFALO M.D.

Urology

250 GREEN ST
SUITE 210
GARDNER, MA
ZIP 01440

(978) 669-5522

AYAZ TARIQ MALIK M.D.

Internal Medicine

(Gastroenterology)

250 GREEN ST
STE 212
GARDNER, MA
ZIP 01440

(978) 669-5522

JEFFREY D. BLAKE M.D.

Obstetrics & Gynecology

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-5050

ANDREA M. DAMOUR M.D.

Obstetrics & Gynecology

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-5050

CHRISTINE M. MCMAHON FNP-C

Nurse Practitioner

(Family)

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-5050

MICHAEL J. MUTCHLER M.D.

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 669-0199

MICHELE C. PARKER M.D.

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 669-0199

JOHN M. SKRZYPCZAK M.D.

Emergency Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-6280

MOTKAR V. REDDY M.D.

Internal Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 632-4324

ROBERT J. TERLATO M.D.

Internal Medicine

(Cardiovascular Disease)

250 GREEN ST
SUITE 110
GARDNER, MA
ZIP 01440

(978) 630-5020

REBECCA M. WORDEN M.D.

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 632-6445

JOHN WORDEN M.D.

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-6445

FRANCIS W. SWEENEY M.D.

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-4455

DAVID C. FLEMMING MD

Anesthesiology

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-6267

CHAIR CITY FAMILY MEDICINE, PC

Family Medicine

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-4455

PETER BRASSARD M.D.

Orthopaedic Surgery

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 632-0800

TRICIA VORDERSTRASSE MD PC

Family Medicine

250 GREEN ST
SUITE 1 06
GARDNER, MA
ZIP 01440

(978) 249-1791

CYRUS VAKILI M.D.

Surgery

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-4452

STEVEN K. BRANCH, MD, PHD, PC

Surgery

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 630-5040

MICHAEL AZZONI, MD

Orthopaedic Surgery

250 GREEN ST
GARDNER, MA
ZIP 01440

(978) 632-0383

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558383588, enumerated as an "individual" on July 25, 2006.

The provider is located at 250 GREEN ST GARDNER, MA 01440 and the phone number is (978) 630-5020.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.

Michael Stauder is affiliated with: HEYWOOD HOSPITAL, UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS, ST VINCENT HOSPITAL and ATHOL MEMORIAL HOSPITAL.