KYLE T. HALLIGAN M.D.
NPI 1922412808
Internal Medicine - Pulmonary Disease in Worcester, MA

Active since June 18, 2014PECOS EnrolledAccepts Medicare Assignment
97.02/100
CMS Quality Rating
55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1975 Get Directions Write a Review

NPPES record last updated: July 3, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 3, 2024, Nov 13, 2020, May 15, 2020 and 1 more (4 updates tracked since 2018).

About Kyle T. Halligan M.d. NPPES

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

KYLE T. HALLIGAN M.D. (NPI 1922412808) is an individual pulmonary disease provider in Worcester, Massachusetts, licensed in Massachusetts (283088) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1922412808
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameKYLE T. HALLIGANCredential: M.D.
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateJune 18, 2014
Last NPPES UpdateJuly 3, 20244 updates tracked since enumeration
NPPES CertifiedJuly 3, 2024
NPI 1922412808 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 · 283088
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 283088 (MA)
55 LAKE AVE N, Worcester, MA 01655

Other Identifiers 1

Medicaid110127819AMA

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

Kyle T. Halligan 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 ID9234405192
PECOS Enrollment IDI20200623000880
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 13

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 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.
115 services68 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.
76 services27 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.
75 services54 patients
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.
59 services34 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
50 services50 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
46 services46 patients

Hospital Affiliations CMS Care Compare 3

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 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
Quality78.09
Promoting Interoperability100
Improvement Activities40

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.

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier20 claims20 services$3.29 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers41 claims41 services$64.62 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers20 claims20 services$32.60 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers11 claims11 services$26.09 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.

Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655

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 Kyle Halligan's NPI number?

The NPI number for Kyle Halligan is 1922412808. It was assigned to this individual provider in the NPPES registry on June 18, 2014.

Where is Kyle Halligan located?

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

What is Kyle Halligan's specialty?

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

Is Kyle Halligan enrolled in Medicare?

Yes. Kyle Halligan 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.

Is Kyle Halligan affiliated with any hospitals?

According to CMS data, Kyle Halligan is affiliated with Umass Memorial Healthalliance Hospitals, Umass Memorial Health - Harrington Hospital and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Kyle Halligan was last updated on July 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.