DR. BRANDON ELLIS PRIORESCHI M.D.
NPI 1659638948
Orthopaedic Surgery in Middletown, CT
NPI Status: Active since April 12, 2012
Contact Information
512 SAYBROOK RD STE 100
MIDDLETOWN, CT
ZIP 06457
Phone: (860) 347-7636
- Individual
- Male
- Years of Experience 14
- Orthopaedic Surgery
- Accepts Medicare Approved Payment
- PECOS Enrolled
About BRANDON PRIORESCHI
This page provides the complete NPI Profile along with additional information for Brandon Prioreschi, a provider established in Middletown, Connecticut with a medical specialization in Orthopaedic Surgery and more than 14 years of experience. He graduated from Albany Medical College Of Union University in 2012. The healthcare provider is registered in the NPI registry with number 1659638948 assigned on April 2012. The practitioner's primary taxonomy code is 207X00000X with license number 71106 (CT). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1659638948
- Provider Name
- DR. BRANDON ELLIS PRIORESCHI M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 512 SAYBROOK RD STE 100 MIDDLETOWN, CT 06457
- Location Phone
- (860) 347-7636
- Mailing Address
- 512 SAYBROOK RD STE 100 MIDDLETOWN, CT 06457
- Medical School Name
- ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
- Graduation Year
- 2012
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-12-2012
- Last Update Date
- 08-05-2022
- Code Navigator
Location Map
Secondary Locations
- 1 Medical Center Dr DHMC Department of Orthopaedic Surgery
Lebanon, NH 03756
(603) 650-5133 - PSC 455 Box 208
FPO, AP 96540
(671) 488-0279 - PSC 455 Box 208
FPO, AP 96540
(671) 488-0279 - 1 Boone Rd
Bremerton, WA 98312
(360) 475-4000
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
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 71106
- License State
- CT
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
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.
*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 |
|---|---|---|---|
| 1659638948 | MEDICAID (05) | NH |
Medicare Participation & PECOS Enrollment Status
Brandon Prioreschi 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.
Brandon Prioreschi 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: 3476859620
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: I20220805001166
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.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Hip replacement
Injection, methylprednisolone acetate, 40 mg
Knee replacement
Lower limb (leg) arthroscopy (minimally invasive joint repair)
Replacement of knee joint, both sides of knee
Upper limb (arm) arthroscopy (minimally invasive joint repair)
X-ray of knee, 4 or more views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 26 times for 26 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 12 times for 11 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 37 times for 27 patientsA hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.
This service was performed for 54 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 36 times for 14 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 42 patientsLower limb arthroscopy is a minimally invasive procedure that allows doctors to examine and repair issues in your leg joints. It involves making small incisions through which a tiny camera and instruments are inserted. This technique can help diagnose and treat various joint problems with less pain and quicker recovery time.
This service was performed for 1-10 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 20 times for 20 patientsUpper limb arthroscopy is a minimally invasive procedure used to examine and treat issues within your arm's joints. A small camera, called an arthroscope, is inserted through a tiny incision, providing a clear view of the joint. This method often results in less pain and faster recovery compared to open surgery.
This service was performed for 1-10 patientsAn X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
This service was performed 18 times for 15 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.46 for a new patient copayment and $18.88 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 06457 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $93.86
- Minimum New Patient Price $60.82
- Maximum New Patient Price $183.1
- Average New Patient Copayment $23.46
- Minimum New Patient Copayment $15.2
- Maximum New Patient Copayment $45.77
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.55
- Minimum Established Patient Price $19.76
- Maximum Established Patient Price $149.26
- Average Established Patient Copayment $18.88
- Minimum Established Patient Copayment $4.94
- Maximum Established Patient Copayment $37.31
* 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.
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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 1659638948, 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.
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 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
MIDDLETOWN, CT 06457
MIDDLETOWN, CT 06457
MIDDLETOWN, CT 06457
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1659638948, enumerated as an "individual" on April 12, 2012.
The provider is located at 512 SAYBROOK RD STE 100 MIDDLETOWN, CT 06457 and the phone number is (860) 347-7636.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.