DR. FRANCIS ANTHONY GAROFALO M.D.
NPI 1821095365
Urology in Gardner, MA

Q: What is Francis Garofalo's NPI number?

The NPI number for Francis Garofalo is 1821095365. It was assigned to this individual provider in the NPPES registry on June 30, 2005.

Q: What is Francis Garofalo's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Francis Garofalo was last updated on April 27, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 30, 2005PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

250 GREEN ST, SUITE 210, GARDNER, MA 01440(978) 669-5522(978) 669-5521 Get Directions Write a Review

NPPES record last updated: April 27, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Francis Anthony Garofalo M.d. NPPES

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

DR. FRANCIS ANTHONY GAROFALO M.D. (NPI 1821095365) is an individual urology provider in Gardner, Massachusetts, licensed in Massachusetts (238888) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Heywood Hospital, and is a graduate of New York Medical College (1984).

NPPES Registry Identity

NPI1821095365

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. FRANCIS ANTHONY GAROFALOCredential: M.D.

Location Address250 GREEN ST, SUITE 210Gardner, MA 01440-1396

Mailing Address250 Green St, Suite 210Gardner, MA 01440-1396 · (978) 669-5522 · Fax (978) 669-5521

Phone(978) 669-5522

Fax(978) 669-5521

Sole ProprietorNo

Medical School CMSNew York Medical CollegeGraduated 1984

Enumeration DateJune 30, 2005

Last NPPES UpdateApril 27, 2011

✔ NPI 1821095365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in MA · 238888

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

250 GREEN ST, Gardner, MA 01440

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Other Identifiers 13

Other349140UT · Dmba Provider

Other85609UT · Pehp Provider

Other266885UT · Altius Provider

Other005575304UT · Humana Provider

Medicare UPIN001032901MA

Medicare ID-Type Unspecified005575304UT · Medicare Provider

Other60119791200001UT · Bcbs Provider

Medicare UPINE04345UT

Medicare UPIN001032902MA

Other107042289101UT · Ihc Provider

Medicare PIN117648AZ

Other870562879GARUT · Emia Provider

OtherPOO262946UT · Rr Mcare Provider

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. Francis Anthony Garofalo 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 ID3779509211

PECOS Enrollment IDI20090422000084

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, 30-39 minutes 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.

294 services252 patients

New patient office or other outpatient visit, 45-59 minutes 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.

88 services88 patients

Established patient office or other outpatient visit, 20-29 minutes 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.

59 services49 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

51 services47 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

42 services19 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

31 services31 patients

Hospital Affiliations CMS Care Compare 2

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

Heywood Hospital

Acute Care Hospitals · Gardner, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220095

Location242 Green StreetGardner, MA 01440 · Worcester County

Emergency services Birthing friendly

Athol Memorial Hospital

Critical Access Hospitals · Athol, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number221303

Location2033 Main StreetAthol, MA 01331 · Worcester County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01440 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

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

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.

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

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%1,340 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

25%158 patients2/55-star benchmark: 88%

Medication Reconciliation

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.

98%630 patients4/55-star benchmark: 100%

Patient-Specific Education

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.

45%1,405 patients2/55-star benchmark: 97%

Provide Patient Access

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…

99%1,405 patients4/55-star benchmark: 100%

Secure Messaging

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…

24%1,405 patients2/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

27%1,405 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

2 suppliers12 claims1,740 services$0.10 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

5 suppliers29 claims6,600 services$1.70 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers13 claims28 services$7.21 avg. paid by Medicare

Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358

DME-Orthotic Devices · category DF000N

4 suppliers21 claims94 services$5.16 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

AYAZ TARIQ MALIK M.D.

Internal Medicine (Gastroenterology)

250 GREEN ST, STE 212
GARDNER, MA 01440

Worcester County (978) 669-5522

JEFFREY D. BLAKE M.D.

Obstetrics & Gynecology