MIGUEL ANGEL CONCEPCION M.D.
NPI 1619101052
Family Medicine - Sports Medicine in Swampscott, MA
NPI Status: Active since May 13, 2009
Contact Information
250 PARADISE RD
SWAMPSCOTT, MA
ZIP 01907
Phone: (781) 596-2000
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Group Taxonomy
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 17
- Family Medicine
- Sports Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MIGUEL CONCEPCION
This page provides the complete NPI Profile along with additional information for Miguel Concepcion, a primary care provider established in Swampscott, Massachusetts with a medical specialization in Family Medicine, focusing in sports medicine and more than 17 years of experience. He graduated from University Of Massachusetts Medical School in 2009. The healthcare provider is registered in the NPI registry with number 1619101052 assigned on May 2009. The practitioner's primary taxonomy code is 207QS0010X with license number 254419 (MA). The provider is registered as an individual and his NPI record was last updated 5 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization.
- NPI
- 1619101052
- Provider Name
- MIGUEL ANGEL CONCEPCION M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 250 PARADISE RD SWAMPSCOTT, MA 01907
- Location Phone
- (781) 596-2000
- Mailing Address
- 250 PARADISE RD SWAMPSCOTT, MA 01907
- Mailing Phone
- (781) 596-2000
- Medical School Name
- UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
- Graduation Year
- 2009
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 05-13-2009
- Last Update Date
- 04-22-2021
- Code Navigator
A primary care provider (PCP) like Miguel Concepcion 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
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
Family Medicine Sports Medicine
- Taxonomy Code
- 207QS0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 254419
- License State
- MA
- Taxonomy Description
- A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
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) |
|---|---|---|---|---|
| 1 | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | 113368 (FL) |
| 2 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program | 241172 (MA) |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Miguel Concepcion 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.
Miguel Concepcion 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: 5193961381
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: I20130729000912
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-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
5 DME suppliers used 14 Medicare Claims 43 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
4 DME suppliers used 11 Medicare Claims 22 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
2 DME suppliers used 11 Medicare Claims 11 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)
2 DME suppliers used 11 Medicare Claims 1290 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.
Administration of influenza virus vaccine
Administration of pneumococcal vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Blood test, basic group of blood chemicals (calcium, total)
Blood test, comprehensive group of blood chemicals
Cholesterol level
Complete blood cell count (red cells, white blood cell, platelets), automated test
Creatinine level to test for kidney function or muscle injury
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Hdl cholesterol level
Hemoglobin a1c level
Influenza vaccine split virus, preservative free
Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage
Injection, methylprednisolone acetate, 40 mg
Insertion of needle into vein for collection of blood sample
Ldl cholesterol level
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
Prostate cancer screening; prostate specific antigen test (psa)
Telephone medical discussion with physician, 11-20 minutes
Urine microalbumin (protein) level
X-ray of chest, 2 views
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 52 times for 51 patientsThe pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
This service was performed 31 times for 31 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 81 times for 81 patientsA basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.
This service was performed 13 times for 12 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 53 times for 53 patientsA cholesterol level test is a blood test that helps evaluate your risk of heart disease. It measures the amount of different types of cholesterol in your blood, including "good" (HDL) and "bad" (LDL) cholesterol. High cholesterol can lead to blockages in your blood vessels, so regular testing is important for maintaining heart health.
This service was performed 53 times for 52 patientsA complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.
This service was performed 13 times for 13 patientsA creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.
This service was performed 23 times for 23 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 163 times for 114 patientsThis 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 189 times for 114 patientsHDL cholesterol level refers to the amount of high-density lipoprotein cholesterol in your blood. Known as 'good' cholesterol, it helps remove other forms of cholesterol from your bloodstream. Higher levels of HDL cholesterol are associated with a lower risk of heart disease.
This service was performed 53 times for 52 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 44 times for 32 patientsThe Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
This service was performed 31 times for 30 patientsThe quadrivalent influenza vaccine is a shot to protect you from four different flu viruses. It's preservative-free and given in a 0.5 ml dose. It helps your body build immunity to the flu, reducing your risk of getting sick.
This service was performed 15 times for 15 patientsMethylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
This service was performed 16 times for 11 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 15 times for 15 patientsThe LDL cholesterol level is a test that measures the amount of low-density lipoprotein (LDL) in your blood. LDL is often referred to as 'bad cholesterol' because high levels can lead to heart disease. Regular testing helps monitor and manage your heart health.
This service was performed 53 times for 52 patientsThe Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
This service was performed 27 times for 27 patientsProstate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.
This service was performed 17 times for 17 patientsThis is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
This service was performed 14 times for 13 patientsThe urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
This service was performed 23 times for 23 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 12 times for 11 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 for a new patient copayment and $25.87 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 01907 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 99214
- Average Established Patient Price $103.48
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $25.87
- 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. Miguel Concepcion is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| NORTH SHORE MEDICAL CENTER - | 81 HIGHLAND AVENUE SALEM, MA 01970 | (978) 741-1215 | Acute Care Hospitals | |
| MASSACHUSETTS GENERAL HOSPITAL | 55 FRUIT STREET BOSTON, MA 02114 | (617) 724-9725 | 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 1619101052, we treat the final digit (2) 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 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
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 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619101052, enumerated as an "individual" on May 13, 2009.
The provider is located at 250 PARADISE RD SWAMPSCOTT, MA 01907 and the phone number is (781) 596-2000.
Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
Miguel Concepcion is affiliated with: NORTH SHORE MEDICAL CENTER - and MASSACHUSETTS GENERAL HOSPITAL.
