ELENA GKROUZMAN MD
NPI 1598100299
Internal Medicine - Rheumatology in Worcester, MA

Q: What is Elena Gkrouzman's NPI number?

The NPI number for Elena Gkrouzman is 1598100299. It was assigned to this individual provider in the NPPES registry on May 8, 2013.

Q: What is Elena Gkrouzman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Elena Gkrouzman was last updated on November 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 08, 2013PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

119 BELMONT ST, WORCESTER, MA 01605(508) 334-5224(508) 334-5654 Get Directions Write a Review

NPPES record last updated: November 9, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 9, 2020, Aug 20, 2020, Feb 4, 2020 and 1 more (4 updates tracked since 2019).

On this page

About Elena Gkrouzman Md NPPES

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

ELENA GKROUZMAN MD (NPI 1598100299) is an individual rheumatology provider in Worcester, Massachusetts, licensed in Massachusetts (283647) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1598100299

Entity TypeIndividualFemale

Primary Taxonomy207RR0500X

Provider Legal NameELENA GKROUZMANCredential: MD

Location Address119 BELMONT STWorcester, MA 01605-2903

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(508) 334-5224

Fax(508) 334-5654

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateMay 8, 2013

Last NPPES UpdateNovember 9, 20204 updates tracked since enumeration

NPPES CertifiedNovember 9, 2020

✔ NPI 1598100299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in MA · 283647

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

119 BELMONT ST, Worcester, MA 01605

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Other Identifiers 1

Medicaid110165074AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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

Elena Gkrouzman 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 ID2769701846

PECOS Enrollment IDI20200929001405

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 6

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

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.

75 services63 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

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.

56 services46 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

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.

37 services37 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

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.

26 services22 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

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.

19 services19 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

18 services15 patients

Hospital Affiliations CMS Care Compare 4

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 Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220019

Location100 South StreetSouthbridge, MA 01550 · 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 01605 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

$134.47 typical visit price

range $58.86 – $177.36

Typical copayment $33.61 (range $14.71 – $44.34)

Most-billed visit code 99204

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

Quality

78.09

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

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