DR. MICHAEL HERCULES THEODOULOU D.P.M. NPI 1760430755

Podiatrist in Somerville, MA

NPI 1760430755 Individual Male Years of Experience 32 Podiatrist PECOS Enrolled Accepts Medicare Approved Payment

About MICHAEL THEODOULOU

Michael Theodoulou is a provider established in Somerville, Massachusetts and his medical specialization is podiatrist with more than 32 years of experience. The NPI number of Michael Theodoulou is 1760430755 and was assigned on May 2006. The practitioner's primary taxonomy code is 213E00000X with license number 2358 (MA). The provider is registered as an individual and his NPI record was last updated 10 years ago.

A podiatrist like Dr. Michael Hercules Theodoulou D.p.m. provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

Michael Theodoulou is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA)

Michael Theodoulou is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Cambridge Health Alliance.

NPI

1760430755

Provider NameDR. MICHAEL HERCULES THEODOULOU D.P.M.
Provider Location Address230 HIGHLAND AVE SOMERVILLE, MA 02143
Provider Mailing Address230 HIGHLAND AVE SOMERVILLE, MA 02143
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1989
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date05-04-2006
Last Update Date12-08-2011


Primary Taxonomy

Taxonomy Code213E00000X
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
License No.2358
License StateMA
Taxonomy DescriptionA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Business Address

DR. MICHAEL HERCULES THEODOULOU D.P.M.
230 HIGHLAND AVE
SOMERVILLE, MA
ZIP 02143
Phone: (617) 665-1000

Get Directions


Mailing Address

DR. MICHAEL HERCULES THEODOULOU D.P.M.
230 HIGHLAND AVE
SOMERVILLE, MA
ZIP 02143
Phone: (617) 665-1000



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID6800849779
PECOS Enrollment IDI20100310000052
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 order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesNo

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 38Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • 16Removal of 2 to 4 thickened skin growths (HCPCS:11056)
  • 14Removal of single thickened skin growth (HCPCS:11055)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Theodoulou is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
CAMBRIDGE HEALTH ALLIANCE1493 CAMBRIDGE STREET
CAMBRIDGE, MA 2138
(617) 665-2300Acute Care Hospitals220011

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristPO558DCNo

Taxonomy Description: a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

2213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist01073MDNo

Taxonomy Description: a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0014612MEDICARE PIN (08)MA
607382MEDICARE ID-TYPE UNSPECIFIED (04)MD
U28344MEDICARE UPIN (02)MD
110084502AMEDICAID (05)MA
0481710001MEDICARE NSC (07)DC

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1760481501DR. MICHAEL CLARENCE PAYNE M.D., M.P.H.
Individual
Internal Medicine (Gastroenterology)230 HIGHLAND AVE SOMERVILLE HOSPITAL / THE CAMBRIDGE HEALTH ALLIANCE
SOMERVILLE, MA 02143
(617) 665-1000
1659352748DR. LJILJANA GRKOVICH MD
Individual
Anesthesiology230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 666-4400
1336111020DR. LOU ANN BRUNO-MURTHA D.O.
Individual
Internal Medicine (Infectious Disease)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4780
1164476503 INGO H STUBBE MD
Individual
Internal Medicine230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4920
1417021437 MANISH TANDON MD
Individual
Internal Medicine (Gastroenterology)230 HIGHLAND AVE MEDICAL SPECIALTIES
SOMERVILLE, MA 02143
(617) 665-1552
1154498889 RALPH H UPCHURCH MD
Individual
Emergency Medicine230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4707
1225181910 SARAH BANSEN APRN
Individual
Nurse Practitioner (Obstetrics & Gynecology)230 HIGHLAND AVE WOMEN'S HEALTH CENTER
SOMERVILLE, MA 02143
(617) 591-4800
1538212089 KAREN LEFKOWITZ APRN
Individual
Nurse Practitioner230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-6300
1538212071 EVELYN NEIMAN APRN
Individual
Nurse Practitioner230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4800
1366651465 BARBARA J KOPPEL LICSW
Individual
Social Worker (Clinical)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 491-4786
1174732119 EMILY J SPEAGLE LICSW
Individual
Social Worker (Clinical)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4484
1376753848DR. XIA THAI PHARM.D.
Individual
Pharmacist (Pharmacotherapy)230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4192
1306040290MRS. AUNKSIKA ANN SLAYTON OTR.L
Individual
Occupational Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1861696866MS. AMYBETH LYNCH PT
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4266
1811191711MRS. SELENA CHANA KUTIN P.T
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4240
1922202852MR. REID FUJIMORI DPT, MSPT
Individual
Physical Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1790980282MISS JENNIFER ANN PURDY COTAL
Individual
Occupational Therapy Assistant230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4276
1588869481MRS. NICOLE PATRICIA STEWART MS, OTR L
Individual
Occupational Therapist230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4500
1265638209 MARLA DRISCOLL RN
Individual
Registered Nurse230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4350
1487850392 ELAINE CATALOGNA RN
Individual
Registered Nurse230 HIGHLAND AVE
SOMERVILLE, MA 02143
(617) 591-4350

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.