CAROLINE SIZER M.D.
NPI 1932492022
Physical Medicine & Rehabilitation - Brain Injury Medicine in Braintree, MA
NPI Status: Active since May 23, 2011
Contact Information
250 POND ST
BRAINTREE, MA
ZIP 02184
Phone: (781) 348-2202
Fax: (781) 348-3989
- Individual
- Female
- Years of Experience 15
- Physical Medicine & Rehabilitation
- Brain Injury Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About CAROLINE SIZER
This page provides the complete NPI Profile along with additional information for Caroline Sizer, a provider established in Braintree, Massachusetts with a medical specialization in Physical Medicine & Rehabilitation, focusing in brain injury medicine and more than 15 years of experience. The healthcare provider is registered in the NPI registry with number 1932492022 assigned on May 2011. The practitioner's primary taxonomy code is 2081P0301X with license number 263051 (MA). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1932492022
- Provider Name
- CAROLINE SIZER M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 250 POND ST BRAINTREE, MA 02184
- Location Phone
- (781) 348-2202
- Location Fax
- (781) 348-3989
- Mailing Address
- 250 POND ST BRAINTREE, MA 02184
- Mailing Phone
- (781) 348-2202
- Mailing Fax
- (781) 348-3989
- Medical School Name
- OTHER
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-23-2011
- Last Update Date
- 10-07-2024
- 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
Physical Medicine & Rehabilitation Brain Injury Medicine
- Taxonomy Code
- 2081P0301X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 263051
- License State
- MA
- Taxonomy Description
- A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences.
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
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Caroline Sizer 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.
Caroline Sizer 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: 5395023295
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: I20210818001940
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
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.
Destruction of peripheral nerve or branch
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Initial nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, each additional extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity
Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity
Injection, onabotulinumtoxina, 1 unit
Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle
New patient office or other outpatient visit, 45-59 minutes
Destruction of a peripheral nerve or branch is a procedure to treat nerve-related pain. It involves using heat, cold, or chemicals to damage or destroy the nerve, thereby blocking pain signals to the brain. This can provide long-term pain relief.
This service was performed 38 times for 15 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 24 times for 23 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 64 times for 50 patientsThis 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.
This service was performed 16 times for 11 patientsA follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
This service was performed 638 times for 174 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 184 times for 86 patientsAn initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
This service was performed 127 times for 122 patientsAn initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
This service was performed 98 times for 96 patientsThis procedure involves injecting a special chemical into 1-4 muscles in an arm or leg to temporarily paralyze them. This can help manage pain or muscle disorders. If needed, the process can be repeated on an additional limb.
This service was performed 89 times for 48 patientsThis procedure involves injecting a chemical into specific muscles in your arm or leg, causing temporary paralysis. It targets 1-4 muscles in the first extremity. It's often used to manage conditions that cause muscle spasms or overactivity.
This service was performed 131 times for 71 patientsThis procedure involves injecting a chemical into specific muscles in an arm or leg to temporarily paralyze them. It's typically used to manage muscular disorders or reduce muscle activity. The process targets 5 or more muscles in the first extremity.
This service was performed 38 times for 25 patientsOnabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
This service was performed 54,600 times for 87 patientsThis procedure involves a needle that measures the electrical activity in your muscles. A chemical is then injected to temporarily paralyze the nerve muscle. This helps in diagnosing and treating certain muscle or nerve conditions.
This service was performed 176 times for 89 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 24 times for 24 patientsQuality 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 |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Patient-Specific Education | 38% | 94 |
| 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 | 99% | 94 |
| 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 | 3% | 94 |
| 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. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 | 9 | 3 | 2 | 4 | 9 | 2 | 0 | 2 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 6 | 2 | 8 | 9 | 4 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 6 + 2 + 8 + 9 + 4 + 0 + 4 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1932492022 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
BARBARA JEAN WYNTER ANP
Nurse Practitioner
(Adult Health)
250 POND ST
BRAINTREE, MA
ZIP 02184
DR. CAROL A. LEAVELL PH.D.
Clinical Neuropsychologist
250 POND ST
BRAINTREE, MA
ZIP 02184
LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC
Psychologist
250 POND ST
LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC.
BRAINTREE, MA
ZIP 02184
ROBERT J. VAN STRIEN M.D.
Physical Medicine & Rehabilitation
250 POND ST
BRAINTREE, MA
ZIP 02184
JAMES F. MCGARRY III M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
CHRISTOPHER C. STEEVENS M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
JOHN E. SCOLA M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
JERRY M. DOSHEN M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
JOHN A TENBROOK, JR. M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
RANDALL LEE OTTO PHD
Psychologist
250 POND ST
BRAINTREE, MA
ZIP 02184
DR. JOHN CHRISTOPHER FAHEY PHD
Psychologist
(Clinical)
250 POND ST
BRAINTREE, MA
ZIP 02184
ANNE MARIE LASOSKI PSY.D.
Clinical Neuropsychologist
250 POND ST
BRAINTREE, MA
ZIP 02184
FIVE STAR QUALITY CARE CT
Prosthetic/Orthotic Supplier
250 POND ST
BRAINTREE, MA
ZIP 02184
MR. ALEXANDER ROBERT BURNHAM MS, CCC-SLP
Speech-Language Pathologist
250 POND ST
BRAINTREE, MA
ZIP 02184
MRS. MARIA C. GRILLO C.O.T.A.
Specialist
250 POND ST
BRAINTREE, MA
ZIP 02184
JANET C LIMKE MD LLC
Physical Medicine & Rehabilitation
250 POND ST
BRAINTREE REHAB HOSPITAL
BRAINTREE, MA
ZIP 02184
DR. JASON GRUNES M.D.
Internal Medicine
250 POND ST
BRAINTREE, MA
ZIP 02184
FIVE STAR QUALITY CARE BRAINTREE REHABILITAITON HOSPITAL
Rehabilitation Hospital
(Children)
250 POND ST
BRAINTREE, MA
ZIP 02184
DR. SARA ILENE COHEN MD
Physical Medicine & Rehabilitation
250 POND ST
BRAINTREE, MA
ZIP 02184
ZACHARY BOHART MD LTD
Physical Medicine & Rehabilitation
250 POND ST
BRAINTREE, MA
ZIP 02184
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1932492022, enumerated as an "individual" on May 23, 2011.
The provider is located at 250 POND ST BRAINTREE, MA 02184 and the phone number is (781) 348-2202.
Physical Medicine & Rehabilitation with taxonomy code 2081P0301X and a focus in Brain Injury Medicine.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
