Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

THEODORE SCHLEY RADER IV MD, MS
NPI 1710477146
Internal Medicine - Infectious Disease in Worcester, MA

Active since May 10, 2018PECOS Enrolled
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(774) 441-8230 Get Directions Write a Review

NPPES record last updated: July 25, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 25, 2026, Mar 31, 2025, Aug 30, 2023 and 2 more (5 updates tracked since 2018).

About Theodore Schley Rader Iv Md, Ms NPPES

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

THEODORE SCHLEY RADER IV MD, MS (NPI 1710477146) is an individual infectious disease provider in Worcester, Massachusetts, licensed in Massachusetts (1015690) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Health - Harrington Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1710477146
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameTHEODORE SCHLEY RADER IVCredential: MD, MS
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (412) 647-5809
Sole ProprietorNo
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 2018
Enumeration DateMay 10, 2018
Last NPPES UpdateJuly 25, 20265 updates tracked since enumeration
NPPES CertifiedJuly 25, 2026
NPI 1710477146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
Licenses Licensed in MA · 1015690 Licensed in OH · 35.156954
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
55 LAKE AVE N, Worcester, MA 01655

Secondary Practice Locations 3

Location 155 Sayles StSouthbridge, MA 01550-1729 · Phone (508) 764-2400
Location 2119 Belmont StWorcester, MA 01605-2903 · Phone (774) 441-8230
Location 39500 Euclid AveCleveland, OH 44195-0001 · Phone (216) 444-2200

Accepted 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

Theodore Schley Rader Iv Md, Ms 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 ID9234486028
PECOS Enrollment IDI20230915000209
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 6

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.

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.
92 services56 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
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.
68 services68 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.
67 services46 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
20 services19 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.
16 services12 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 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Umass Memorial Health - Harrington Hospital

Acute Care Hospitals · Southbridge, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220019
Location100 South StreetSouthbridge, MA 01550 · Worcester County
Emergency services

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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

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.

Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655

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 Theodore Rader's NPI number?

The NPI number for Theodore Rader is 1710477146. It was assigned to this individual provider in the NPPES registry on May 10, 2018.

Where is Theodore Rader located?

Theodore Rader practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (774) 441-8230.

What is Theodore Rader's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Theodore Rader enrolled in Medicare?

Yes. Theodore Rader 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 Theodore Rader accept?

Health plans from Anthem Blue Cross and Blue Shield list Theodore Rader 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 Theodore Rader affiliated with any hospitals?

According to CMS data, Theodore Rader is affiliated with Umass Memorial Health - Harrington Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Theodore Rader was last updated on July 25, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.