DR. ALOK KAPOOR M.D.
NPI 1942258819
Internal Medicine in Worcester, MA
NPI Status: Active since May 04, 2006
Contact Information
55 LAKE AVE N
WORCESTER, MA
ZIP 01655
Phone: (508) 334-8515
Fax: (508) 334-6490
- Individual
- Male
- Years of Experience 26
- Internal Medicine
- PECOS Enrolled
- Accepts Medicare Approved Payment
About ALOK KAPOOR
Alok Kapoor is an internist established in Worcester, Massachusetts and his medical specialization is Internal Medicine with more than 26 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 1998. The healthcare provider is registered in the NPI registry with number 1942258819 assigned on May 2006. The practitioner's primary taxonomy code is 207R00000X with license number 223099 (MA). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1942258819
- Provider Name
- DR. ALOK KAPOOR M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 55 LAKE AVE N WORCESTER, MA 01655
- Location Phone
- (508) 334-8515
- Location Fax
- (508) 334-6490
- Mailing Address
- PO BOX 415348 BOSTON, MA 02241
- Mailing Phone
- (800) 225-8885
- Mailing Fax
- (508) 334-6490
- Medical School Name
- ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
- Graduation Year
- 1998
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-04-2006
- Last Update Date
- 11-25-2020
- Code Navigator
An internist like Alok Kapoor is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Alok Kapoor 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.
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.07 for a new patient copayment and $27.15 for an established patient copayment.
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
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 223099
- License State
- MA
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110041292A | MEDICAID (05) | MA |
PECOS Enrollment and Medicare Participation Status
Alok Kapoor 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: 9032141890
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: I20050901000446
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
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 01655 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $140.28
- Minimum New Patient Price $61.32
- Maximum New Patient Price $185.12
- Average New Patient Copayment $35.07
- Minimum New Patient Copayment $15.33
- Maximum New Patient Copayment $46.28
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $108.63
- Minimum Established Patient Price $19.31
- Maximum Established Patient Price $151.47
- Average Established Patient Copayment $27.15
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $37.86
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Hospital Affiliations
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Alok Kapoor is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS | 55 LAKE AVENUE NORTH WORCESTER, MA 1655 | (508) 334-1000 | Acute Care Hospitals |
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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 | 4 | 2 | 2 | 5 | 8 | 8 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 8 | 2 | 4 | 5 | 16 | 8 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 8 + 2 + 4 + 5 + 1 + 6 + 8 + 2 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1942258819 is valid because the calculated check digit 9 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.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1457352775 | DR. SARAH BETH SAXER PHARMD Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N UMASS MED CENTER DEPT OF PHARMACY WORCESTER, MA 01655 (508) 856-2763 |
| 1891797361 | MARTHA LAROSE SAMPSON CRNA Individual | Nurse Anesthetist, Certified Registered | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1902899370 | LINDA A PAPE M.D. Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N CARDIOLOGY WORCESTER, MA 01655 (508) 856-3050 |
| 1124013271 | DR. DALE E RAUCH M.D. Individual | Psychiatry & Neurology (Psychiatry) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-6580 |
| 1225025562 | DR. MAICHI T TRAN PHARM.D. Individual | Pharmacist (Pharmacotherapy) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-1618 |
| 1427045509 | DR. JENNIFER L DONOVAN PHARM.D. Individual | Pharmacist | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-4101 |
| 1215925516 | JESSICA L DOUGLAS MS Individual | Genetic Counselor, MS | 55 LAKE AVE N S1-710 WORCESTER, MA 01655 (508) 334-3517 |
| 1295723310 | DR. JULIANNE PATRICIA HUBER MD Individual | Emergency Medicine | 55 LAKE AVE N WORCESTER, MA 01655 (508) 421-1400 |
| 1013906999 | DR. CHRISTIAN HARTMAN PHARMD Individual | 55 LAKE AVE N PHARMACY DEPARTMENT WORCESTER, MA 01655 (508) 334-7832 | |
| 1609866607 | ELLEN M GRAVALLESE M.D. Individual | Internal Medicine (Rheumatology) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 334-5224 |
| 1437149804 | RAIMIS MATULIONIS MD Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1497745806 | DR. ABIGAIL ADAMS M.D. Individual | Internal Medicine | 55 LAKE AVE N DEPARTMENT OF GENERAL MEDICINE WORCESTER, MA 01655 (508) 856-2731 |
| 1710977046 | GAMZE AYATA MD Individual | Pathology (Anatomic Pathology) | 55 LAKE AVE N DEPARTMENT OF PATHOLOGY WORCESTER, MA 01655 (508) 793-6100 |
| 1821088139 | DR. MARIANNE E FELICE M.D. Individual | Pediatrics (Adolescent Medicine) | 55 LAKE AVE N DEPARTMENT OF PEDIATRIC ADOLESCENT MEDICINE WORCESTER, MA 01655 (508) 856-3199 |
| 1750371910 | SUYANG HAO MD Individual | Pathology (Anatomic Pathology) | 55 LAKE AVE N DEPARTMENT OF PATHOLOGY WORCESTER, MA 01655 (508) 793-6100 |
| 1437140308 | JOHN PULLERITS M.D. Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1558352492 | DIANA I. KOUZNETSOV MD Individual | Anesthesiology | 55 LAKE AVE N DEPARTMENT OF ANESTHESIOLOGY WORCESTER, MA 01655 (508) 334-3271 |
| 1174514764 | OSCAR EPHRAM STAROBIN MD Individual | Internal Medicine (Cardiovascular Disease) | 55 LAKE AVE N WORCESTER, MA 01655 (508) 856-3603 |
| 1942291570 | DR. STANLEY K TAM MD Individual | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 55 LAKE AVE N DEPARTMENT OF SURGERY WORCESTER, MA 01655 (508) 334-3962 |
| 1558352922 | MICHAEL C. BUTLER MD Individual | Emergency Medicine | 55 LAKE AVE N DEPARTMENT OF EMERGENCY MEDICINE WORCESTER, MA 01655 (508) 421-1400 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942258819, enumerated in the NPI registry as an "individual" on May 04, 2006
The provider is located at 55 Lake Ave N Worcester, Ma 01655 and the phone number is (508) 334-8515
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider has more than 26 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 1998.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $140.28 with an average copayment of $35.07 for new patient appointments. Established patients should expect a typical charge of $108.63 and an average copayment of 27.15. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on May 04, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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