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ERIKA N ZIMMONS DO
NPI 1942373535
Family Medicine in Worcester, MA

Active since November 15, 2006PECOS EnrolledAccepts Medicare Assignment
291 LINCOLN ST, WORCESTER, MA 01605(508) 344-6251 Get Directions Write a Review

NPPES record last updated: May 1, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Erika N Zimmons Do NPPES

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

ERIKA N ZIMMONS DO (NPI 1942373535) is an individual family medicine provider in Worcester, Massachusetts, licensed in Massachusetts (248976) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Umass Memorial Health - Harrington Hospital, and is a graduate of Ohio University, College Of Osteopathic Medicine (2006).

NPPES Registry Identity

NPI1942373535
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameERIKA N ZIMMONSCredential: DO
Location Address291 LINCOLN STWorcester, MA 01605-3643
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885
Phone(508) 344-6251
Sole ProprietorNo
Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 2006
Enumeration DateNovember 15, 2006
Last NPPES UpdateMay 1, 2022
NPPES CertifiedMay 1, 2022
✔ NPI 1942373535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MA · 248976
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
291 LINCOLN ST, Worcester, MA 01605
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Other Names 1

Former Name (1)Erika Oleson

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

Erika N Zimmons Do 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 ID1254502693
PECOS Enrollment IDI20110915000637
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 9

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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A 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.
56 services34 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.
55 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 services33 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
34 services34 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
28 services21 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A 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.
19 services12 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 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 01605 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
$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.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers11 claims23 services$4.89 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
3 suppliers11 claims425 services$0.23 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$12.38 avg. paid by Medicare
Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$27.92 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers11 claims2,921 services$0.03 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers14 claims14 services$26.06 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.

DR. MARY R HAWTHORNE M.D.
Internal Medicine
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 791-8524
DR. JAMES E FANALE M.D.
Internal Medicine
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 334-6251
SEVIL HEMAYAT M.D
Internal Medicine
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 791-8524
MARIAN SABA MD
Internal Medicine
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 791-8524
MS. TRACY M. CORMIER NP
Nurse Practitioner
291 LINCOLN ST, EMPLOYEE HEALTH
WORCESTER, MA 01605
Worcester County (508) 793-6400
DR. HAWA OZIEN ABU MD
Internal Medicine (Geriatric Medicine)
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 334-6251
DOUGLAS MISAEL PALACIOS HERNANDEZ
Internal Medicine
291 LINCOLN ST
WORCESTER, MA 01605
Worcester County (508) 799-2922
HAHNEMANN UROLOGY ASSOCIATES, INC.
Urology
291 LINCOLN ST, SUITE 201
WORCESTER, MA 01605
Worcester County (508) 755-8663

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 Erika Zimmons's NPI number?

The NPI number for Erika Zimmons is 1942373535. It was assigned to this individual provider in the NPPES registry on November 15, 2006. The provider is also known as Erika Oleson.

Where is Erika Zimmons located?

Erika Zimmons practices at 291 Lincoln St, Worcester, MA 01605. The listed phone number is (508) 344-6251.

What is Erika Zimmons's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Erika Zimmons enrolled in Medicare?

Yes. Erika Zimmons 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 Erika Zimmons accept?

Health plans from Anthem Blue Cross and Blue Shield list Erika Zimmons 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 Erika Zimmons affiliated with any hospitals?

According to CMS data, Erika Zimmons is affiliated with 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 Erika Zimmons was last updated on May 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.