MS. SUSAN LYNNE DEBALSI PA-C
NPI 1649318288
Physician Assistant - Medical in Fairhaven, MA

NPI Status: Active since February 04, 2007

Contact Information

200 MILL ROAD
SUITE 190
FAIRHAVEN, MA
ZIP 02719
Phone: (508) 973-2160
Fax: (508) 973-2176

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  • Individual
  • Female
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About SUSAN DEBALSI

This page provides the complete NPI Profile along with additional information for Susan Debalsi, a primary care provider established in Fairhaven, Massachusetts with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1649318288 assigned on February 2007. The practitioner's primary taxonomy code is 363AM0700X with license number PA1212 (MA). The provider is registered as an individual and her NPI record was last updated 2 years ago.

NPI
1649318288
Provider Name
MS. SUSAN LYNNE DEBALSI PA-C
Gender
Female
Entity Type
Individual
Location Address
200 MILL ROAD SUITE 190 FAIRHAVEN, MA 02719
Location Phone
(508) 973-2160
Location Fax
(508) 973-2176
Mailing Address
200 MILL RD SUITE 180 FAIRHAVEN, MA 02719
Mailing Phone
(508) 973-3000
Mailing Fax
(508) 973-2176
Is Sole Proprietor?
No
Enumeration Date
02-04-2007
Last Update Date
10-31-2024
Code Navigator

A primary care provider (PCP) like Susan Debalsi 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

Secondary Locations

  • 110 Liberty St
    Brockton, MA 02301
    (508) 941-7000

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

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA1212
License State
MA

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)
1363AM0700XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant
Medical

1212 (MA)
2363AM0700XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant
Medical

PA00663 (RI)

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

Susan Debalsi 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

  • 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.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 600 times for 73 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 16 times for 15 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 11 times for 11 patients

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 Plan 17% 54
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan

Reviews for MS. SUSAN LYNNE DEBALSI PA-C

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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 1649318288, we treat the final digit (8) 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 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

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
6
Unchanged
Pos 3
4
Doubled → 8
Pos 4
9
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
8
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 4 → 8 3 → 6 8 → 16 → 7 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 8 + 9 + 6 + 1 + 1 + 6 + 2 + 1 + 6 + 24 = 72

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

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1649318288.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Nurse Practitioner (Adult Health)
200 MILL ROAD, SUITE 180
FAIRHAVEN, MA 02719
Nurse Practitioner (Adult Health)
200 MILL ROAD, SUITE 180
FAIRHAVEN, MA 02719
Family Medicine
200 MILL ROAD, SUITE 180
FAIRHAVEN, MA 02719
Nurse Practitioner (Family)
200 MILL ROAD, SUITE 190
FAIRHAVEN, MA 02719

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649318288, enumerated as an "individual" on February 04, 2007.

The provider is located at 200 MILL ROAD SUITE 190 FAIRHAVEN, MA 02719 and the phone number is (508) 973-2160.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

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