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DR. ANDREW PENN WORDEN M.D.
NPI 1699160994
Surgery in Marshall, MI

Active since April 02, 2015PECOS EnrolledAccepts Medicare Assignment
92.05/100
CMS Quality Rating
215 E MANSION ST STE 3E, MARSHALL, MI 49068(269) 781-4267 Get Directions Write a Review

NPPES record last updated: September 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Andrew Penn Worden M.d. NPPES

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

DR. ANDREW PENN WORDEN M.D. (NPI 1699160994) is an individual surgery provider in Marshall, Michigan, licensed in Michigan (4301505392) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Oaklawn Hospital, and maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1699160994
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. ANDREW PENN WORDENCredential: M.D.
Location Address215 E MANSION ST STE 3EMarshall, MI 49068-1559
Mailing Address200 N Madison StMarshall, MI 49068-1143 · (269) 789-7181
Phone(269) 781-4267
Sole ProprietorYes
Medical School CMSWayne State University School Of MedicineGraduated 2015
Enumeration DateApril 2, 2015
Last NPPES UpdateSeptember 10, 2021
NPPES CertifiedSeptember 10, 2021
✔ NPI 1699160994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MI · 4301505392
Definition
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.
215 E MANSION ST STE 3E, Marshall, MI 49068
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Secondary Practice Location 1

Location 12799 W Grand BlvdDetroit, MI 48202-2608 · Phone (313) 916-1601

Other Identifiers 1

Medicaid1699160994MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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. Andrew Penn Worden 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 ID1658685938
PECOS Enrollment IDI20210927001001
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 7

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This 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.
17 services17 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
14 services14 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This 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.
13 services13 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.
13 services12 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.
12 services11 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
12 services12 patients

Hospital Affiliations CMS Care Compare

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

Oaklawn Hospital

Acute Care Hospitals · Marshall, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230217
Location200 N MadisonMarshall, MI 49068 · Calhoun County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49068 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

92.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.19
Promoting Interoperability97
Improvement Activities40

Reported Quality Measures

Advance Care Plan
53%216 patients3/55-star benchmark: 100%
Breast Cancer Screening
40%93 patients2/55-star benchmark: 93%
Cervical Cancer Screening
21%98 patients1/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
100%33 patients5/55-star benchmark: 87%
Colorectal Cancer Screening
58%254 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
83%119 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
41%82 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
29%82 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
70%805 patients3/55-star benchmark: 100%
e-Prescribing
96%187 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
87%445 patients4/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
18%427 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 80% · 490 patients
Patients screened: 95% · 490 patients
42%121 patients2/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
59%276 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THERESA KLEE D.O.
Surgery
215 E MANSION ST STE 3E
MARSHALL, MI 49068
Calhoun County (269) 781-4267
DR. MATTHEW STEVEN RALPH D.O.
Surgery
215 E MANSION ST STE 3E
MARSHALL, MI 49068
Calhoun County (269) 781-4267

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 Andrew Worden's NPI number?

The NPI number for Andrew Worden is 1699160994. It was assigned to this individual provider in the NPPES registry on April 2, 2015.

Where is Andrew Worden located?

Andrew Worden practices at 215 E Mansion St Ste 3E, Marshall, MI 49068. The listed phone number is (269) 781-4267.

What is Andrew Worden's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Andrew Worden enrolled in Medicare?

Yes. Andrew Worden 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 Andrew Worden accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Andrew Worden 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 Andrew Worden affiliated with any hospitals?

According to CMS data, Andrew Worden is affiliated with Oaklawn Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Worden was last updated on September 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.