DR. JOHN T WHALEN MD
NPI 1720055130
Orthopaedic Surgery in Albany, NY

Q: What is John Whalen's NPI number?

The NPI number for John Whalen is 1720055130. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Q: What is John Whalen's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for John Whalen was last updated on May 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since March 03, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

121 EVERETT RD, ALBANY, NY 12205(518) 489-2663(518) 689-3881 Get Directions Write a Review

NPPES record last updated: May 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 28, 2025, Dec 8, 2023, Mar 7, 2023 and 2 more (5 updates tracked since 2022).

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About Dr. John T Whalen Md NPPES

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

DR. JOHN T WHALEN MD (NPI 1720055130) is an individual orthopaedic surgery provider in Albany, New York, licensed in New York (190181) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and is a graduate of Yale University School Of Medicine (1989).

NPPES Registry Identity

NPI1720055130

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. JOHN T WHALENCredential: MD

Location Address121 EVERETT RDAlbany, NY 12205-1474

Mailing Address121 Everett RdAlbany, NY 12205-1474 · (518) 489-2663 · Fax (518) 689-3881

Phone(518) 489-2663

Fax(518) 689-3881

Sole ProprietorNo

Medical School CMSYale University School Of MedicineGraduated 1989

Enumeration DateMarch 3, 2006

Last NPPES UpdateMay 28, 20255 updates tracked since enumeration

NPPES CertifiedMay 28, 2025

✔ NPI 1720055130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NY · 190181

Definition

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.

Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License 190181 (NY)

121 EVERETT RD, Albany, NY 12205

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Other Identifiers 1

Medicaid01586507NY

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. John T Whalen Md 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 ID143212217

PECOS Enrollment IDI20100913000949

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 23

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.

99 services83 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

76 services74 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

64 services32 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

38 services35 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

38 services35 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

31 services27 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.

31 services26 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.

25 services25 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

23 services17 patients

X-ray of upper spine, 4-5 views 72050

An X-ray of the upper spine with 4-5 views is a non-invasive imaging test. It uses radiation to capture detailed images of the bones and structures in your neck and upper back. This procedure helps identify issues like fractures, infections, or deformities.

23 services18 patients

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.

23 services23 patients

Mri scan of upper spinal canal without contrast 72141

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

22 services11 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.

22 services22 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

21 services20 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.

20 services20 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

18 services18 patients

Fusion of spine in lower back with partial removal of spine bone and disc 22633

This procedure, called lumbar spinal fusion, involves joining two or more vertebrae in your lower back. It includes a partial removal of a spine bone and disc to alleviate pain and improve stability. The goal is to reduce motion between vertebrae and prevent nerve irritation.

15 services15 patients

X-ray of knee, 4 or more views 73564

An 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.

15 services13 patients

Placement of stabilizing device to back of 1 spine bone in neck 22840

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

14 services14 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

12 services12 patients

Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back 63052

This procedure involves the partial removal of a bone segment in your lower back to relieve pressure on your spinal cord or nerves. It's usually done during a spinal fusion in the lower back, which helps to stabilize your spine by joining two or more vertebrae together.

12 services12 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

12 services12 patients

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Peter's Hospital

Acute Care Hospitals · Albany, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330057

Location315 South Manning BoulevardAlbany, NY 12208 · Albany County

Emergency services Birthing friendly

Samaritan Hospital Of Troy, New York

Acute Care Hospitals · Troy, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330180

Location2215 Burdett AvenueTroy, NY 12180 · Rensselaer County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12205 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

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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.

KAREN L BERTASSO PA

Physician Assistant (Surgical)