DR. KENNETH MICHAEL RALTO M.D.
NPI 1770877193
Internal Medicine - Nephrology in Worcester, MA

Q: What is Kenneth Ralto's NPI number?

The NPI number for Kenneth Ralto is 1770877193. It was assigned to this individual provider in the NPPES registry on June 2, 2011.

Q: What is Kenneth Ralto's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Ralto was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 02, 2011PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

55 LAKE AVE N, WORCESTER, MA 01655(508) 856-3155(508) 856-3111 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 28, 2021, Nov 18, 2020, May 15, 2018 and 1 more (4 updates tracked since 2016).

On this page

About Dr. Kenneth Michael Ralto M.d. NPPES

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

DR. KENNETH MICHAEL RALTO M.D. (NPI 1770877193) is an individual nephrology provider in Worcester, Massachusetts, licensed in Massachusetts (265176) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1770877193

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. KENNETH MICHAEL RALTOCredential: M.D.

Location Address55 LAKE AVE NWorcester, MA 01655

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(508) 856-3155

Fax(508) 856-3111

Sole ProprietorNo

Medical School CMSTufts University School Of MedicineGraduated 2011

Enumeration DateJune 2, 2011

Last NPPES UpdateJuly 28, 20214 updates tracked since enumeration

NPPES CertifiedJuly 28, 2021

✔ NPI 1770877193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in MA · 265176

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedInternal MedicineTaxonomy 207R00000X · License 265176 (MA)

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 265176 (MA)

55 LAKE AVE N, Worcester, MA 01655

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Secondary Practice Locations 2

Location 1157 Union StMarlborough, MA 01752-1228 · Phone (508) 486-5435

Location 285 Prescott StWorcester, MA 01605-2610 · Phone (508) 856-3155

Other Identifiers 1

Medicaid110124521AMA

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. Kenneth Michael Ralto 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 ID840563391

PECOS Enrollment IDI20180808000320

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 12

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.

236 services126 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

136 services73 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.

101 services70 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

85 services18 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

58 services28 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.

49 services48 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

47 services33 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

42 services15 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.

33 services33 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.

26 services25 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

18 services14 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

13 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220001

Location60 Hospital RoadLeominster, MA 01453 · Worcester County

Emergency services

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 Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220049

Location157 Union StreetMarlborough, MA 01752 · Middlesex County

Emergency services

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220090

Location14 Prospect StreetMilford, MA 01757 · Worcester County

Emergency services Birthing friendly

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

Quality

78.09

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

HILLARY R. IRONS MD

Emergency Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 421-1400

MS. EILEEN A. DUHAMEL NP

Nurse Practitioner

55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-2710

EWA HRYNISZYN CRNA

Nurse Anesthetist, Certified Registered

55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

HELEN COPSEY PA-C

Physician Assistant

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-8585

DR. ADEPEJU GBADEBO CHAMPION M.D.

Internal Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-2731

SOWMYA KORAPATI

Internal Medicine (Hematology & Oncology)

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-3550

LAYLA FAKHRZADEH M.D.

Anesthesiology

55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

YOONYIE CHO M.D.

Anesthesiology

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-1000

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 Kenneth Ralto's NPI number?

The NPI number for Kenneth Ralto is 1770877193. It was assigned to this individual provider in the NPPES registry on June 2, 2011.

Where is Kenneth Ralto located?

Kenneth Ralto practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 856-3155.

What is Kenneth Ralto's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Kenneth Ralto enrolled in Medicare?

Yes. Kenneth Ralto 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 Kenneth Ralto accept?

Health plans from Anthem Blue Cross and Blue Shield list Kenneth Ralto 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 Kenneth Ralto affiliated with any hospitals?

According to CMS data, Kenneth Ralto is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Health - Harrington Hospital, Umass Memorial Healthcare-Marlborough Hospital, Milford Regional Medical Center and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Kenneth Ralto was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.