WILLIAM MICHAEL WHALEN II M.D.
NPI 1912386871
Internal Medicine - Pulmonary Disease in Worcester, MA

Q: What is William Whalen's NPI number?

The NPI number for William Whalen is 1912386871. It was assigned to this individual provider in the NPPES registry on May 26, 2015.

Q: What is William Whalen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for William Whalen was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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 May 26, 2015PECOS EnrolledAccepts Medicare Assignment

55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1975 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 5, 2025, Apr 3, 2024, Mar 9, 2022 (3 updates tracked since 2022).

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About William Michael Whalen Ii M.d. NPPES

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

WILLIAM MICHAEL WHALEN II M.D. (NPI 1912386871) is an individual pulmonary disease provider in Worcester, Massachusetts, licensed in Massachusetts (273430) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and maintains a secondary practice location in Worcester.

NPPES Registry Identity

NPI1912386871

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameWILLIAM MICHAEL WHALEN IICredential: M.D.

Location Address55 LAKE AVE NWorcester, MA 01655-0002

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

Phone(508) 334-1975

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateMay 26, 2015

Last NPPES UpdateJune 5, 20253 updates tracked since enumeration

NPPES CertifiedJune 5, 2025

✔ NPI 1912386871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in MA · 273430

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 273430 (MA)

55 LAKE AVE N, Worcester, MA 01655

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Secondary Practice Location 1

Location 1119 Belmont StWorcester, MA 01605-2903 · Phone (508) 334-1975

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

William Michael Whalen Ii 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 ID749579340

PECOS Enrollment IDI20180510001586

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 10

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.

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.

63 services39 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.

60 services48 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.

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.

30 services23 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

26 services21 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

22 services18 patients

Hospital Affiliations CMS Care Compare 4

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

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.

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 William Whalen's NPI number?

The NPI number for William Whalen is 1912386871. It was assigned to this individual provider in the NPPES registry on May 26, 2015.

Where is William Whalen located?

William Whalen practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-1975.

What is William Whalen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is William Whalen enrolled in Medicare?

Yes. William Whalen 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 William Whalen accept?

Health plans from Anthem Blue Cross and Blue Shield list William Whalen 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 William Whalen affiliated with any hospitals?

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

When was this NPI record last updated?

The NPPES record for William Whalen was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.