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MILAGROS LOPEZ GERENA
NPI 1922460039
Surgery in Springfield, MA

Active since March 28, 2016PECOS EnrolledAccepts Medicare Assignment
70.94/100
CMS Quality Rating
BAYSTATE MEDICAL CENTER, 759 CHESTNUT STREET, SPRINGFIELD, MA 01199(413) 794-0000 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 31, 2024, Mar 28, 2016 (2 updates tracked since 2016).

About Milagros Lopez Gerena NPPES

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

MILAGROS LOPEZ GERENA (NPI 1922460039) is an individual surgery provider in Springfield, Massachusetts, licensed in Maryland (D0096711) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS, is affiliated with Garrett Regional Medical Center, and maintains a secondary practice location in Oakland.

NPPES Registry Identity

NPI1922460039
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameMILAGROS LOPEZ GERENA
Location AddressBAYSTATE MEDICAL CENTER, 759 CHESTNUT STREETSpringfield, MA 01199
Mailing AddressBaystate Medical Center, 759 Chestnut StreetSpringfield, MA 01199 · (413) 794-0000
Phone(413) 794-0000
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 28, 2016
Last NPPES UpdateJuly 31, 20242 updates tracked since enumeration
NPPES CertifiedJuly 31, 2024
✔ NPI 1922460039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MD · D0096711
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
BAYSTATE MEDICAL CENTER, Springfield, MA 01199
Open in Google Maps ↗

Secondary Practice Location 1

Location 1255 N 4th St Ste 2Oakland, MD 21550-1340 · Phone (301) 334-8282

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Milagros Lopez Gerena 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 ID2769777473
PECOS Enrollment IDI20230516000332
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.

Medicare Billing Reassignment

Medicare enrollment records show Milagros Lopez Gerena reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Specialty Physicians Of Garrett County, LLC
382 mi
Mental Health (Including Community Mental Health Center)
32 CORPORATE DR
Grantsville, MD 21536
  • Reassigned Medicare billing, Maryland enrollment
  • 120 clinicians in this Medicare group
NPI 1881361442 (301) 895-8750

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.
74 services38 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This 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.
45 services45 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.
36 services32 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
33 services32 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.
27 services26 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.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

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

Garrett Regional Medical Center

Acute Care Hospitals · Oakland, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210017
Location251 North Fourth StreetOakland, MD 21550 · Garrett County
Emergency services Birthing friendly

West Virginia University Hospitals, Inc

Acute Care Hospitals · Morgantown, WV
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510001
Location1 Medical Center DriveMorgantown, WV 26506 · Monongalia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01199 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
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
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.

70.94/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.4
Promoting Interoperability100
Improvement Activities0
Cost76.73

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ZOE HERMIONE WARCZAK M.D.
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER, 759 CHESTNUT STREET
SPRINGFIELD, MA 01199
Hampden County (518) 262-5511
BRANDON SKWARTO DO
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000
CHRISTOPHER WILSON
Anesthesiology
BAYSTATE MEDICAL CENTER
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000
DR. TOMAS PETER JOSEPH REILLY MD
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER, 759 CHESTNUT STREET
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000
DR. PAUL KIM MD
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000
ALBATOOL ABDELGHAFFAR
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000
DR. SHOBHIT KUMAR PRASAD M.D.
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER, 759 CHESTNUT ST
SPRINGFIELD, MA 01199
Hampden County (256) 394-0495
DR. TRISTAN CHAMBERS DO
Student in an Organized Health Care Education/Training Program
BAYSTATE MEDICAL CENTER
SPRINGFIELD, MA 01199
Hampden County (413) 794-0000

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 Milagros Lopez Gerena's NPI number?

The NPI number for Milagros Lopez Gerena is 1922460039. It was assigned to this individual provider in the NPPES registry on March 28, 2016.

Where is Milagros Lopez Gerena located?

Milagros Lopez Gerena practices at Baystate Medical Center 759 Chestnut Street, Springfield, MA 01199. The listed phone number is (413) 794-0000.

What is Milagros Lopez Gerena's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Milagros Lopez Gerena enrolled in Medicare?

Yes. Milagros Lopez Gerena 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.

Which organization bills Medicare for Milagros Lopez Gerena's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Milagros Lopez Gerena reassigns Medicare benefits to Specialty Physicians Of Garrett County, LLC (Grantsville, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Milagros Lopez Gerena's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Milagros Lopez Gerena accept?

Health plans from CareSource list Milagros Lopez Gerena 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 Milagros Lopez Gerena affiliated with any hospitals?

According to CMS data, Milagros Lopez Gerena is affiliated with Garrett Regional Medical Center and West Virginia University Hospitals, Inc.

When was this NPI record last updated?

The NPPES record for Milagros Lopez Gerena was last updated on July 31, 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.