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DR. BRIAN R SZETELA M.D.
NPI 1659353571
Psychiatry & Neurology - Psychiatry in Worcester, MA

Active since November 16, 2005PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, DEPARTMENT OF PSYCHIATRY, WORCESTER, MA 01655(508) 856-6580(508) 856-6426 Get Directions Write a Review

NPPES record last updated: December 8, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 8, 2020, Apr 18, 2017 (2 updates tracked since 2017).

About Dr. Brian R Szetela M.d. NPPES

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

DR. BRIAN R SZETELA M.D. (NPI 1659353571) is an individual psychiatry provider in Worcester, Massachusetts, licensed in Massachusetts (48859) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Medical Center/university Campus, and is a graduate of University Of Vermont College Of Medicine (1979).

NPPES Registry Identity

NPI1659353571
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. BRIAN R SZETELACredential: M.D.
Location Address55 LAKE AVE N, DEPARTMENT OF PSYCHIATRYWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Phone(508) 856-6580
Fax(508) 856-6426
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 1979
Enumeration DateNovember 16, 2005
Last NPPES UpdateDecember 8, 20202 updates tracked since enumeration
NPPES CertifiedDecember 8, 2020
✔ NPI 1659353571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in MA · 48859
Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

55 LAKE AVE N, Worcester, MA 01655
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Other Identifiers 2

Medicaid6186777MA
Medicaid110065264AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.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

Dr. Brian R Szetela M.d. 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 ID840262812
PECOS Enrollment IDI20040810000938
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 8

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 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.
106 services60 patients
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.
63 services40 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.
58 services40 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
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.
34 services26 patients
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.
25 services18 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
25 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

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 01655 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
$177.36 typical visit price
range $58.86 – $177.36
Typical copayment $44.34 (range $14.71 – $44.34)
Most-billed visit code 99205
Established Patient
$73.22 typical visit price
range $19.11 – $144.84
Typical copayment $18.30 (range $4.77 – $36.21)
Most-billed visit code 99213
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
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

DR. SARAH BETH SAXER PHARMD
Pharmacist (Pharmacotherapy)
55 LAKE AVE N, UMASS MED CENTER DEPT OF PHARMACY
WORCESTER, MA 01655
Worcester County (508) 856-2763
MARTHA LAROSE SAMPSON CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
LINDA A PAPE M.D.
Internal Medicine (Cardiovascular Disease)
55 LAKE AVE N, CARDIOLOGY
WORCESTER, MA 01655
Worcester County (508) 856-3050
DR. DALE E RAUCH M.D.
Psychiatry & Neurology (Psychiatry)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 856-6580
DR. MAICHI T TRAN PHARM.D.
Pharmacist (Pharmacotherapy)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 856-1618
JESSICA L DOUGLAS MS
Genetic Counselor, MS
55 LAKE AVE N, S1-710
WORCESTER, MA 01655
Worcester County (508) 334-3517
DR. JULIANNE PATRICIA HUBER MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
ELLEN M GRAVALLESE M.D.
Internal Medicine (Rheumatology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-5224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brian Szetela's NPI number?

The NPI number for Brian Szetela is 1659353571. It was assigned to this individual provider in the NPPES registry on November 16, 2005.

Where is Brian Szetela located?

Brian Szetela practices at 55 Lake Ave N Department Of Psychiatry, Worcester, MA 01655. The listed phone number is (508) 856-6580.

What is Brian Szetela's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Brian Szetela enrolled in Medicare?

Yes. Brian Szetela is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Brian Szetela accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Brian Szetela as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Brian Szetela affiliated with any hospitals?

According to CMS data, Brian Szetela is affiliated with Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Brian Szetela was last updated on December 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.