Active NPI 1174562177 Individual Practitioner Male Practitioner

Dr. Paul F Dufault , MD

Internal Medicine • Worcester, MA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Paul Dufault, MD is a certified Internal Medicine practicing in Worcester, MA. With approximately 44 years of clinical experience since graduating from Tufts University School Of Medicine in 1982, Dr. Dufault delivers high-quality medical care to the local community at 40 CONVERSE ST.

Dr. Dufault accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual alcohol misuse screening, 5 to, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

40 Converse St

Worcester, MA 016052722

Telephone 5087916611

Medicare Profile & Education

Medical School

Tufts University School Of Medicine

Graduation Year

1982

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Worcester, MA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

44 Yrs +24.6 yrs vs City Avg

City Avg: 19.4 Yrs

State Avg: 29.3 Yrs

Regional Practice Density

460 Specialists

Practicing in Worcester, MA (7127 Statewide)

Telehealth Adoption Rate

15.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dufault (44 Years) 44 Yrs

Worcester Specialty Average (19.4 Years) 19.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	408	210	$300.00	$93.72
G0442 Annual alcohol misuse screening, 5 to 15 minutes	202	202	$74.92	$19.83
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	195	195	$225.00	$134.54
G0444 Annual depression screening, 5 to 15 minutes	194	194	$75.00	$19.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	154	107	$349.68	$132.12
99442 Telephone medical discussion with physician, 11-20 minutes	48	36	$103.13	$93.13
99496 Transitional care management services for problem of high complexity	25	22	$300.00	$289.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	19	18	$150.00	$58.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	381	191	$294.49	$93.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	228	137	$349.78	$132.05
G0442 Annual alcohol misuse screening, 5 to 15 minutes	202	202	$75.00	$19.34
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	195	195	$225.64	$133.75
G0444 Annual depression screening, 5 to 15 minutes	194	194	$75.00	$19.34
99442 Telephone medical discussion with physician, 11-20 minutes	84	63	$102.08	$93.20
99496 Transitional care management services for problem of high complexity	35	29	$300.00	$286.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	31	$148.44	$58.79
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	19	14	$200.00	$107.04
99443 Telephone medical discussion with physician, 21-30 minutes	17	11	$150.00	$131.46
99497 Advance care planning, first 30 minutes	15	14	$150.00	$85.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	432	211	$315.16	$134.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	195	195	$225.90	$138.32
G0442 Annual alcohol misuse screening, 5 to 15 minutes	188	188	$75.00	$20.01
G0444 Annual depression screening, 5 to 15 minutes	186	186	$75.00	$19.64
99213 Established patient office or other outpatient visit, typically 15 minutes	177	115	$250.00	$95.59
99442 Telephone medical discussion with physician, 11-20 minutes	65	55	$101.92	$95.01
99443 Telephone medical discussion with physician, 21-30 minutes	46	39	$150.00	$135.06
99496 Transitional care management services for problem of high complexity	31	25	$300.00	$293.98
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$154.17	$59.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	442	218	$299.83	$137.16
G0442 Annual alcohol misuse screening, 5 to 15 minutes	192	192	$75.00	$19.99
G0444 Annual depression screening, 5 to 15 minutes	183	183	$75.00	$19.99
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	174	174	$225.00	$140.46
99213 Established patient office or other outpatient visit, typically 15 minutes	130	87	$250.00	$96.71
99442 Telephone medical discussion with physician, 11-20 minutes	130	85	$100.00	$97.10
99443 Telephone medical discussion with physician, 21-30 minutes	61	50	$150.00	$137.41
99496 Transitional care management services for problem of high complexity	36	30	$300.00	$295.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	12	$150.00	$59.58
99497 Advance care planning, first 30 minutes	14	14	$150.00	$89.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	340	203	$300.00	$115.22
99442 Telephone medical discussion with physician, 11-20 minutes	196	105	$99.74	$80.17
G0442 Annual alcohol misuse screening, 5 to 15 minutes	189	189	$75.00	$19.15
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	178	178	$225.00	$123.46
99213 Established patient office or other outpatient visit, typically 15 minutes	157	104	$250.00	$78.84
99443 Telephone medical discussion with physician, 21-30 minutes	156	119	$150.00	$116.32
G0444 Annual depression screening, 5 to 15 minutes	153	153	$75.00	$19.38
99497 Advance care planning, first 30 minutes	43	43	$150.00	$90.56
99496 Transitional care management services for problem of high complexity	36	28	$300.00	$260.20
99441 Telephone medical discussion with physician, 5-10 minutes	26	21	$75.00	$48.96
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	22	19	$37.05	$15.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	15	$150.00	$48.50
93000 Routine ekg using at least 12 leads including interpretation and report	15	15	$80.00	$18.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	501	231	$300.00	$114.60
99213 Established patient office or other outpatient visit, typically 15 minutes	245	151	$250.00	$78.36
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	204	204	$225.00	$122.78
G0442 Annual alcohol misuse screening, 5 to 15 minutes	173	173	$75.00	$19.18
G0444 Annual depression screening, 5 to 15 minutes	163	163	$75.00	$19.18
93000 Routine ekg using at least 12 leads including interpretation and report	135	120	$80.00	$18.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	53	42	$150.00	$47.82
99496 Transitional care management services for problem of high complexity	28	26	$300.00	$244.26
99497 Advance care planning, first 30 minutes	17	17	$150.00	$89.29
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$300.00	$175.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	424	222	$300.00	$107.05
99213 Established patient office or other outpatient visit, typically 15 minutes	274	160	$236.22	$72.70
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	190	190	$225.00	$116.07
G0442 Annual alcohol misuse screening, 5 to 15 minutes	87	87	$75.00	$18.33
G0444 Annual depression screening, 5 to 15 minutes	81	81	$75.00	$17.96
93000 Routine ekg using at least 12 leads including interpretation and report	67	62	$80.00	$17.06
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	25	$150.00	$43.88
99496 Transitional care management services for problem of high complexity	24	22	$300.00	$231.52
99497 Advance care planning, first 30 minutes	22	22	$150.00	$83.48
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	14	14	$250.00	$170.78
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$300.00	$163.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	454	239	$290.98	$104.07
99213 Established patient office or other outpatient visit, typically 15 minutes	286	169	$225.00	$70.97
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	202	202	$225.00	$111.56
99497 Advance care planning, first 30 minutes	159	154	$150.00	$78.68
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	158	155	$50.00	$40.79
93000 Routine ekg using at least 12 leads including interpretation and report	122	117	$80.00	$16.53
G0442 Annual alcohol misuse screening, 5 to 15 minutes	95	95	$75.00	$17.48
G0444 Annual depression screening, 5 to 15 minutes	93	93	$75.00	$17.48
99496 Transitional care management services for problem of high complexity	49	37	$300.00	$223.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	36	30	$150.00	$42.53
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	12	12	$300.00	$159.36

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MA 52319

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 26, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 26, 2016

Registered at 40 CONVERSE ST, WORCESTER, MA 016052722 (Tel: 5087916611)

📍

Updated Business Mailing Address July 26, 2016

Registered at 40 CONVERSE ST, WORCESTER, MA 016052722 (Tel: 5087916611)

👤

Provider Name / Credentials Updated July 26, 2016

Recorded as PAUL DUFAULT, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 26, 2016

Internal Medicine (License #52319 in MA)

🟢

Initial NPI Registration & Enumeration June 05, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1174562177

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 05, 2006

Last Update: July 26, 2016

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

40 Converse St

Worcester, MA 016052722

Phone: 5087916611

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.