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DR. SEAN WHELTON M.D.
NPI 1659370757
Internal Medicine - Rheumatology in Washington, DC

Active since July 20, 2005PECOS EnrolledAccepts Medicare Assignment
76.55/100
CMS Quality Rating
3800 RESERVOIR RD NW, WASHINGTON, DC 20007(202) 687-8233(202) 687-8579 Get Directions Write a Review

NPPES record last updated: March 15, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Sean Whelton M.d. NPPES

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

DR. SEAN WHELTON M.D. (NPI 1659370757) is an individual rheumatology provider in Washington, District Of Columbia, licensed in District Of Columbia (MD32259) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Tulane University School Of Medicine (1997).

NPPES Registry Identity

NPI1659370757
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameDR. SEAN WHELTONCredential: M.D.
Location Address3800 RESERVOIR RD NWWashington, DC 20007-2113
Mailing AddressPo Box 418283Boston, MA 02241-8283 · (703) 558-1544
Phone(202) 687-8233
Fax(202) 687-8579
Sole ProprietorNo
Medical School CMSTulane University School Of MedicineGraduated 1997
Enumeration DateJuly 20, 2005
Last NPPES UpdateMarch 15, 2012
✔ NPI 1659370757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses✔ Licensed in DC · MD32259✔ Licensed in VA · 0101058120
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.

3800 RESERVOIR RD NW, Washington, DC 20007
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Other Identifiers 6

Medicare ID-Type Unspecified009718G65
Medicare ID-Type Unspecified110238486
Medicare UPINH65046
Medicaid033957100DC
Medicaid3679918000MD
Medicaid5474122VA

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. Sean Whelton 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 ID8224214374
PECOS Enrollment IDI20110525000591
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 4

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.
120 services64 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.
42 services27 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
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.
27 services15 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20007 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

76.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.16
Promoting Interoperability100
Improvement Activities40
Cost55.94

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. KAUSTUBH SUBHASH YADWADKAR M.D.
Radiology (Diagnostic Radiology)
3800 RESERVOIR RD NW, CG201
WASHINGTON, DC 20007
District of Columbia (304) 206-7595
FRED MO MD
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-8766
SEBLE YIRGA
Nurse Practitioner (Family)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-7265
ARLETTE THOMPSON-PILE
Physical Therapy Assistant
3800 RESERVOIR RD NW, PHYSICAL MEDICINE AND REHBAILITATION DEPARTMENT
WASHINGTON, DC 20007
District of Columbia (202) 444-3689
JENNA ELIZABETH HOROWITZ
Physician Assistant (Surgical)
3800 RESERVOIR RD NW, NEUROSURGERY DEPARTMENT
WASHINGTON, DC 20007
District of Columbia (202) 444-2000
HALEY SWANSON FOSTER M.D.
Radiology (Vascular & Interventional Radiology)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-5022
SOPHIA RIZVI MD
Radiology (Radiation Oncology)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-2000
CLAIRE DALBY MD
Student in an Organized Health Care Education/Training Program
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-7106

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 Sean Whelton's NPI number?

The NPI number for Sean Whelton is 1659370757. It was assigned to this individual provider in the NPPES registry on July 20, 2005.

Where is Sean Whelton located?

Sean Whelton practices at 3800 Reservoir Rd NW, Washington, DC 20007. The listed phone number is (202) 687-8233.

What is Sean Whelton's specialty?

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

Is Sean Whelton enrolled in Medicare?

Yes. Sean Whelton 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.

When was this NPI record last updated?

The NPPES record for Sean Whelton was last updated on March 15, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.