Individual provider Active NPI

Thomas Peponis, MD

  • Colon & Rectal Surgery Physician
  • Worcester, MA
National Provider Identifier
1306376538
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
1015489 Issued in MA
Practice address
67 Belmont St
Worcester, MA 01605-2657
Phone
(508) 334-8195
Fax
(508) 334-8130
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 271242 MA
Colon & Rectal Surgery Physician 208C00000X 70847 MN
Colon & Rectal Surgery Physician 208C00000X 1015489 MA Primary

Addresses

Primary practice location

67 Belmont St
Worcester, MA 01605-2657

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

200 1st St SW
Rochester, MN 55905-0002
Phone (507) 284-2511

Other practice location 2

Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817003490 MA Practitioner - Colorectal Surgery (Proctology) 4587937891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

67 Belmont St
Worcester, MA 01605-2657
Phone (508) 334-8996

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1015489MAMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Surgery CurrentSince Sep 11, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

67 Belmont St
Worcester, MA 01605
Phone (508) 334-8996

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1306376538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052657",
            "telephone_number": "508-334-8195",
            "fax_number": "508-334-8130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050002",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Massachusetts General Hospital",
            "address_2": "55 Fruit St.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02114",
            "country_code": "US",
            "telephone_number": "617-726-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEPONIS",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "271242",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MN",
            "license": "70847",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MA",
            "license": "1015489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.