KEVIN SEAN TOMANY MD
NPI 1790746675
Orthopaedic Surgery in N Chelmsford, MA
NPI Status: Active since March 30, 2006
Contact Information
10 RESEARCH PLACE
N CHELMSFORD, MA
ZIP 01863
Phone: (978) 275-9650
Fax: (978) 275-9552
- Individual
- Male
- Years of Experience 34
- Orthopaedic Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About KEVIN TOMANY
This page provides the complete NPI Profile along with additional information for Kevin Tomany, a provider established in N Chelmsford, Massachusetts with a medical specialization in Orthopaedic Surgery and more than 34 years of experience. He graduated from Jefferson Medical College Of Thomas Jefferson University in 1992. The healthcare provider is registered in the NPI registry with number 1790746675 assigned on March 2006. The practitioner's primary taxonomy code is 207X00000X with license number 156606 (MA). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1790746675
- Provider Name
- KEVIN SEAN TOMANY MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 10 RESEARCH PLACE N CHELMSFORD, MA 01863
- Location Phone
- (978) 275-9650
- Location Fax
- (978) 275-9552
- Mailing Address
- 10 RESEARCH PL STE 203 NORTH CHELMSFORD, MA 01863
- Mailing Phone
- (978) 275-9650
- Mailing Fax
- (978) 275-9552
- Medical School Name
- JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
- Graduation Year
- 1992
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 03-30-2006
- Last Update Date
- 06-10-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 156606
- License State
- MA
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| A23774 | MEDICARE ID-TYPE UNSPECIFIED (04) | ||
| G11647 | MEDICARE UPIN (02) | ||
| 3182622 | MEDICAID (05) | MA |
Medicare Participation & PECOS Enrollment Status
Kevin Tomany is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Kevin Tomany is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3577598168
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20051003000451
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF000N)
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type (HCPCS:L3809)
1 DME suppliers used 21 Medicare Claims 23 Services Paid
DME-Orthotic Devices (DF000N)
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf (HCPCS:L3908)
1 DME suppliers used 33 Medicare Claims 39 Services Paid
DME-Orthotic Devices (DF000N)
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf (HCPCS:L3924)
1 DME suppliers used 18 Medicare Claims 23 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Aspiration and/or injection of fluid from medium joint
Aspiration and/or injection of fluid from small joint
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Injection into tendon or ligament
Injection, methylprednisolone acetate, 40 mg
Injection, methylprednisolone acetate, 80 mg
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Release of wrist ligament using an endoscope
Upper limb (arm) arthroscopy (minimally invasive joint repair)
X-ray of elbow, minimum of 3 views
X-ray of hand, minimum of 3 views
X-ray of shoulder, minimum of 2 views
X-ray of wrist, minimum of 3 views
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 83 times for 60 patientsThis procedure involves a needle being inserted into a medium-sized joint, such as a knee or shoulder, to remove (aspirate) excess fluid. Sometimes, medication may also be injected into the joint to reduce inflammation and pain.
This service was performed 62 times for 49 patientsThis procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.
This service was performed 13 times for 12 patientsThis 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.
This service was performed 371 times for 207 patientsThis 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.
This service was performed 49 times for 44 patientsAn injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
This service was performed 71 times for 58 patientsMethylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.
This service was performed 158 times for 110 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 83 times for 60 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 1-10 patientsThis 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.
This service was performed 142 times for 142 patientsThis 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.
This service was performed 18 times for 18 patientsThis procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.
This service was performed 25 times for 24 patientsUpper limb arthroscopy is a minimally invasive procedure used to examine and treat issues within your arm's joints. A small camera, called an arthroscope, is inserted through a tiny incision, providing a clear view of the joint. This method often results in less pain and faster recovery compared to open surgery.
This service was performed for 46 patientsAn elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.
This service was performed 32 times for 21 patientsAn X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.
This service was performed 215 times for 177 patientsAn 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.
This service was performed 65 times for 60 patientsAn X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
This service was performed 61 times for 28 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.41 for a new patient copayment and $19.71 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 01863 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $97.64
- Minimum New Patient Price $63.72
- Maximum New Patient Price $189.86
- Average New Patient Copayment $24.41
- Minimum New Patient Copayment $15.93
- Maximum New Patient Copayment $47.46
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $78.84
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $19.71
- Minimum Established Patient Copayment $5.26
- Maximum Established Patient Copayment $38.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| e-Prescribing | 100% | 98 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Medication Reconciliation | 95% | 4729 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Patient-Specific Education | 22% | 2207 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 70% | 2207 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Secure Messaging | 1% | 2207 |
| For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical 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. Kevin Tomany is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| LOWELL GENERAL HOSPITAL | 295 VARNUM AVENUE LOWELL, MA 01854 | (978) 937-6000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 9 | 0 | 7 | 4 | 6 | 6 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 18 | 0 | 14 | 4 | 12 | 6 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 8 + 0 + 1 + 4 + 4 + 1 + 2 + 6 + 1 + 4 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1790746675 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
MANOUCHER SHADMAN SHIRAZI MD
Orthopaedic Surgery
10 RESEARCH PLACE
N CHELMSFORD, MA
ZIP 01863
REBECCA M NAUGHTON APRN
Nurse Practitioner
(Family)
10 RESEARCH PLACE
NORTH CHELMSFORD, MA
ZIP 01863
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790746675, enumerated as an "individual" on March 30, 2006.
The provider is located at 10 RESEARCH PLACE N CHELMSFORD, MA 01863 and the phone number is (978) 275-9650.
Orthopaedic Surgery with taxonomy code 207X00000X.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
Kevin Tomany is affiliated with: LOWELL GENERAL HOSPITAL.
