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DR. MICHAEL HERCULES THEODOULOU D.P.M.
NPI 1760430755
Podiatrist in Somerville, MA

Active since May 04, 2006PECOS EnrolledAccepts Medicare Assignment
86.26/100
CMS Quality Rating
230 HIGHLAND AVE, SOMERVILLE, MA 02143(617) 665-1000 Get Directions Write a Review

NPPES record last updated: December 8, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael Hercules Theodoulou D.p.m. NPPES

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

DR. MICHAEL HERCULES THEODOULOU D.P.M. (NPI 1760430755) is an individual podiatrist in Somerville, Massachusetts, licensed in Massachusetts (2358) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Cambridge Health Alliance, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1760430755
Entity TypeIndividualMale
Primary Taxonomy213E00000X
Provider Legal NameDR. MICHAEL HERCULES THEODOULOUCredential: D.P.M.
Location Address230 HIGHLAND AVESomerville, MA 02143-1408
Mailing Address230 Highland AveSomerville, MA 02143-1408 · (617) 665-1000
Phone(617) 665-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 1989
Enumeration DateMay 4, 2006
Last NPPES UpdateDecember 8, 2011
✔ NPI 1760430755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Licenses✔ Licensed in MA · 2358✔ Licensed in DC · PO558✔ Licensed in MD · 01073
Definition
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.
230 HIGHLAND AVE, Somerville, MA 02143
Open in Google Maps ↗

Other Identifiers 5

Medicare PIN0014612MA
Medicare ID-Type Unspecified607382MD
Medicare UPINU28344MD
Medicaid110084502AMA
Medicare NSC0481710001DC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. Michael Hercules Theodoulou D.p.m. 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 ID6800849779
PECOS Enrollment IDI20100310000052
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 8

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 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.
163 services113 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.
79 services79 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.
39 services34 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.
33 services28 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.
30 services30 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
24 services20 patients

Hospital Affiliations CMS Care Compare

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

Cambridge Health Alliance

Acute Care Hospitals · Cambridge, MA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number220011
Location1493 Cambridge StreetCambridge, MA 02138 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02143 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

86.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.84
Promoting Interoperability100
Improvement Activities40
Cost58.7

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.

MR. JEAN MARQUES LAFOREST COUNSELOR
Community Health Worker
230 HIGHLAND AVE, S.O.N, ROOM 401
SOMERVILLE, MA 02143
Middlesex County (617) 591-6780
DR. SANDRA FADOUS PHARMD
Pharmacist
230 HIGHLAND AVE
SOMERVILLE, MA 02143
Middlesex County (617) 591-4200
ANGELINA COSTA
Occupational Therapist
230 HIGHLAND AVE
SOMERVILLE, MA 02143
Middlesex County (617) 591-4531
DEBRALEE QUINN MSN, RN
Registered Nurse
230 HIGHLAND AVE, SOMERVILLE HOSPITAL
SOMERVILLE, MA 02143
Middlesex County (617) 591-4500
MRS. SANDRA GONCALVES CAMPOS COUNSELOR
Community Health Worker
230 HIGHLAND AVE, SON, SUITE 405
SOMERVILLE, MA 02143
Middlesex County (617) 591-6783
CAMBRIDGE PUBLIC HEALTH COMMISSION
Psychiatric Unit
230 HIGHLAND AVE
SOMERVILLE, MA 02143
Middlesex County (617) 591-4500
STACEY ELLIOT RN
Registered Nurse
230 HIGHLAND AVE
SOMERVILLE, MA 02143
Middlesex County (617) 591-4500
MR. BARRY RUND
Community Health Worker
230 HIGHLAND AVE
SOMERVILLE, MA 02143
Middlesex County (617) 591-6734

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 Michael Theodoulou's NPI number?

The NPI number for Michael Theodoulou is 1760430755. It was assigned to this individual provider in the NPPES registry on May 4, 2006.

Where is Michael Theodoulou located?

Michael Theodoulou practices at 230 Highland Ave, Somerville, MA 02143. The listed phone number is (617) 665-1000.

What is Michael Theodoulou's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Michael Theodoulou enrolled in Medicare?

Yes. Michael Theodoulou 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 Michael Theodoulou accept?

Health plans from Anthem Blue Cross and Blue Shield list Michael Theodoulou 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 Michael Theodoulou affiliated with any hospitals?

According to CMS data, Michael Theodoulou is affiliated with Cambridge Health Alliance.

When was this NPI record last updated?

The NPPES record for Michael Theodoulou was last updated on December 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.