PETER JOSEPH MAZZAGLIA MD
NPI 1639103617
Surgery in Providence, RI
NPI Status: Active since July 10, 2006
Contact Information
2 DUDLEY ST
SUITE 470
PROVIDENCE, RI
ZIP 02905
Phone: (401) 223-0962
Fax: (401) 861-1272
- Individual
- Male
- Years of Experience 33
- Surgery
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About PETER MAZZAGLIA
This page provides the complete NPI Profile along with additional information for Peter Mazzaglia, a provider established in Providence, Rhode Island with a medical specialization in Surgery and more than 33 years of experience. He graduated from University Of Massachusetts Medical School in 1993. The healthcare provider is registered in the NPI registry with number 1639103617 assigned on July 2006. The practitioner's primary taxonomy code is 208600000X with license number MD12186 (RI). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1639103617
- Provider Name
- PETER JOSEPH MAZZAGLIA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2 DUDLEY ST SUITE 470 PROVIDENCE, RI 02905
- Location Phone
- (401) 223-0962
- Location Fax
- (401) 861-1272
- Mailing Address
- PO BOX 16149 RUMFORD, RI 02916
- Mailing Phone
- (401) 453-9625
- Mailing Fax
- (401) 861-1272
- Medical School Name
- UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-10-2006
- Last Update Date
- 01-29-2020
- Code Navigator
A surgeon like Peter Mazzaglia 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.
- MD12186
- License State
- RI
- 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.
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 |
|---|---|---|---|
| 31703-4 | OTHER (01) | RI | RHODE ISLAND BCBS |
| 7058687 | MEDICAID (05) | RI |
Medicare Participation & PECOS Enrollment Status
Peter Mazzaglia 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.
Peter Mazzaglia 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: 5496799397
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: I20061009000025
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.
Established patient office or other outpatient visit, 10-19 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Fine needle aspiration biopsy using ultrasound guidance, first growth
Hernia repair - groin (open)
Hernia repair (minimally invasive)
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of thyroid lobe on side of neck
Removal or exploration of parathyroid glands
Ultrasound scan of head and neck soft tissue
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 25 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 111 times for 98 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 11 times for 11 patientsFine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.
This service was performed 32 times for 30 patientsHernia repair in the groin area (open) is a surgical procedure to fix a bulge or protrusion, caused by internal tissues pushing through a weak spot in your abdominal wall. In this operation, a small incision is made in the groin area. The protruding tissue is then placed back into the abdomen, and the weakened area is reinforced with stitches or a mesh.
This service was performed for 1-10 patientsHernia repair is a surgery to fix a hernia - a condition where an organ pushes through an opening in the muscle or tissue that holds it in place. Minimally invasive hernia repair involves small incisions, a tiny camera, and special surgical tools. This method often leads to quicker recovery, less pain, and reduced scarring compared to traditional surgery.
This service was performed for 1-10 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 77 times for 77 patientsThis 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 22 times for 22 patientsThis procedure involves the removal of one side of your thyroid gland, located in your neck. It's done to treat conditions like nodules or tumors. You'll be under anesthesia, and the surgeon will make a small incision in your neck to remove the lobe. Recovery typically takes a few weeks.
This service was performed 14 times for 14 patientsThe procedure for removal or exploration of parathyroid glands involves a surgeon making a small incision in the neck to locate and remove one or more of the tiny parathyroid glands. These glands control calcium levels in the body. This procedure helps treat conditions like hyperparathyroidism.
This service was performed 29 times for 28 patientsAn ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
This service was performed 179 times for 169 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.62 for a new patient copayment and $18.23 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 02905 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.48
- Minimum New Patient Price $58.57
- Maximum New Patient Price $177.03
- Average New Patient Copayment $22.62
- Minimum New Patient Copayment $14.64
- Maximum New Patient Copayment $44.25
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.93
- Minimum Established Patient Price $18.92
- Maximum Established Patient Price $144.38
- Average Established Patient Copayment $18.23
- Minimum Established Patient Copayment $4.73
- Maximum Established Patient Copayment $36.09
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care transition documentation practice improvements | Yes | N/A |
| Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.). | ||
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement | Yes | N/A |
| Collection and follow-up on patient experience and satisfaction data on beneficiary engagement, including development of improvement plan. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Documentation of Current Medications in the Medical Record | 100% | 919 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Health Information Exchange | 38% | 348 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes | Yes | N/A |
| Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance. | ||
| Medication Reconciliation | 98% | 1978 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Pain Assessment and Follow-Up | 96% | 693 |
| Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present | ||
| Patient-Specific Education | 75% | 1279 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% | 45 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 89% | 1279 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 13% | 1279 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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. Peter Mazzaglia is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| RHODE ISLAND HOSPITAL | 593 EDDY STREET PROVIDENCE, RI 02903 | (401) 444-4000 | Acute Care Hospitals | |
| THE MIRIAM HOSPITAL | 164 SUMMIT AVENUE PROVIDENCE, RI 02906 | (401) 793-2500 | Acute Care 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. | |||||||||
| 1 | 6 | 3 | 9 | 1 | 0 | 3 | 6 | 1 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 0 | 6 | 6 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 0 + 6 + 6 + 2 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1639103617 is valid because the calculated check digit 7 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.
NORTHEAST ORTHOTICS AND PROSTHETICS INC
Prosthetic/Orthotic Supplier
2 DUDLEY ST
STE 161
PROVIDENCE, RI
ZIP 02905
JOSEPH F. AMARAL MD
Surgery
2 DUDLEY ST
STE 470
PROVIDENCE, RI
ZIP 02905
THOMAS EDWARD CATALDO MD
Colon & Rectal Surgery
2 DUDLEY ST
SUITE 370
PROVIDENCE, RI
ZIP 02905
NORBERT J. CRAYBAS MD
Surgery
2 DUDLEY ST
SUITE 470
PROVIDENCE, RI
ZIP 02905
THOMAS K. SHAHINIAN MD
Surgery
2 DUDLEY ST
SUITE 470
PROVIDENCE, RI
ZIP 02905
ROMAN ARTYM HAYDA MD
Orthopaedic Surgery
2 DUDLEY ST
SUITE 200
PROVIDENCE, RI
ZIP 02905
DR. ARUN K SINGH M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
2 DUDLEY ST
SUITE 470
PROVIDENCE, RI
ZIP 02905
DR. PHILLIP R LUCAS M.D.
Orthopaedic Surgery
(Orthopaedic Surgery of the Spine)
2 DUDLEY ST
PROVIDENCE, RI
ZIP 02905
ANTHONY A CALDAMONE M.D.
Urology
2 DUDLEY ST
SUITE 185
PROVIDENCE, RI
ZIP 02905
PATRICIA SOLGA MD
Orthopaedic Surgery
2 DUDLEY ST
STE 200
PROVIDENCE, RI
ZIP 02905
RICHARD M. TEREK M.D.
Orthopaedic Surgery
2 DUDLEY ST
PROVIDENCE, RI
ZIP 02905
STACIE REGO PT
Specialist
2 DUDLEY ST
SUITE 200
PROVIDENCE, RI
ZIP 02905
JANET L WILTERDINK MD
Psychiatry & Neurology
(Neurology)
2 DUDLEY ST
SUITE 555
PROVIDENCE, RI
ZIP 02905
CHARLENE A TATE MD
Psychiatry & Neurology
(Neurology)
2 DUDLEY ST
SUITE 555
PROVIDENCE, RI
ZIP 02905
KAREN L CARNEY OTR/L CHT
Occupational Therapist
(Hand)
2 DUDLEY ST
SUITE 200
PROVIDENCE, RI
ZIP 02905
J DONALD EASTON MD
Psychiatry & Neurology
(Neurology)
2 DUDLEY ST
SUITE 555
PROVIDENCE, RI
ZIP 02905
ANDREA TAMMARO OTR/L CHT
Occupational Therapist
(Hand)
2 DUDLEY ST
SUITE 200
PROVIDENCE, RI
ZIP 02905
PETER GRIER TRAFTON M.D.
Orthopaedic Surgery
(Orthopaedic Trauma)
2 DUDLEY ST
PROVIDENCE, RI
ZIP 02905
RICHARD J ZIENOWICZ MD
Plastic Surgery
2 DUDLEY ST
STE 380
PROVIDENCE, RI
ZIP 02905
PAUL J RAMOS II PA
Physician Assistant
(Surgical)
2 DUDLEY ST
SUITE 200
PROVIDENCE, RI
ZIP 02905
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639103617, enumerated as an "individual" on July 10, 2006.
The provider is located at 2 DUDLEY ST SUITE 470 PROVIDENCE, RI 02905 and the phone number is (401) 223-0962.
Surgery with taxonomy code 208600000X.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
Peter Mazzaglia is affiliated with: RHODE ISLAND HOSPITAL and THE MIRIAM HOSPITAL.
