Active NPI 1578547600 Individual Practitioner Male Practitioner

Dr. Douglas M Rothkopf , MD

Surgery - Plastic and Reconstructive Surgery • Worcester, MA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Rothkopf, MD is a certified Surgery - Plastic and Reconstructive Surgery practicing in Worcester, MA. With approximately 46 years of clinical experience since graduating from New York University School Of Medicine in 1980, Dr. Rothkopf delivers high-quality medical care to the local community at 281 LINCOLN ST.

Dr. Rothkopf is affiliated with Umass Memorial Medical Group Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

281 Lincoln St
Department Of Plastic & Reconstructive Surgery

Worcester, MA 016052138

Telephone 5083345958

Fax 5083345752

Associated Practice Facility / Clinic

🏢 A Jerome Philbin M.d., P.c. Facility NPI 1659319143

Medicare Profile & Education

Medical School

New York University School Of Medicine

Graduation Year

1980

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Worcester, MA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

46 Yrs +11.5 yrs vs City Avg

City Avg: 34.5 Yrs

State Avg: 34.7 Yrs

Regional Practice Density

10 Specialists

Practicing in Worcester, MA (76 Statewide)

Telehealth Adoption Rate

10.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

79.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Rothkopf (46 Years) 46 Yrs

Worcester Specialty Average (34.5 Years) 34.5 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	155	99	$300.00	$64.65
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	78	78	$359.00	$80.30
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	29	$450.00	$129.03
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$667.00	$171.01
99231 Follow-up hospital inpatient care per day, typically 15 minutes	18	11	$158.00	$48.74
26055 Incision of tendon covering	18	17	$2674.00	$285.36
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	17	16	$4335.00	$1028.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	135	100	$279.67	$66.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	111	111	$359.00	$83.88
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	30	30	$450.00	$132.55
26055 Incision of tendon covering	24	20	$2674.00	$256.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$667.00	$176.86
20550 Injection into tendon or ligament	14	13	$329.00	$38.29
99221 Initial hospital inpatient care per day, typically 30 minutes	13	13	$331.00	$84.46
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	13	13	$4335.00	$1091.76
64721 Release and/or relocation of hand nerve	12	11	$1647.00	$457.99
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	12	12	$4335.00	$1091.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	102	76	$244.00	$66.22
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$359.00	$86.18
99221 Initial hospital inpatient care per day, typically 30 minutes	33	33	$331.00	$103.50
26055 Incision of tendon covering	18	12	$2674.00	$250.75
99282 Emergency department visit with straightforward medical decision making	18	18	$152.00	$43.97
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	16	16	$4335.00	$1117.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	110	75	$239.64	$70.59
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	87	87	$358.43	$86.42
99221 Initial hospital inpatient care per day, typically 30 minutes	39	39	$326.08	$104.67
26055 Incision of tendon covering	16	13	$2667.50	$275.03
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	12	12	$4335.00	$1121.75
99282 Emergency department visit with straightforward medical decision making	12	12	$151.58	$44.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	73	56	$214.00	$54.36
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$349.00	$80.37
99221 Initial hospital inpatient care per day, typically 30 minutes	33	31	$299.00	$107.85
99231 Follow-up hospital inpatient care per day, typically 15 minutes	24	12	$132.00	$41.59
26055 Incision of tendon covering	14	14	$2622.00	$315.01
64721 Release and/or relocation of hand nerve	12	11	$1647.00	$466.87
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	12	12	$4696.25	$1188.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$347.88	$79.88
99213 Established patient office or other outpatient visit, typically 15 minutes	90	63	$212.00	$53.48
99221 Initial hospital inpatient care per day, typically 30 minutes	30	30	$297.87	$106.14
26055 Incision of tendon covering	14	12	$2622.00	$275.60
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	12	12	$4335.00	$1130.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	122	85	$199.00	$53.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	85	85	$342.00	$79.80
99221 Initial hospital inpatient care per day, typically 30 minutes	38	37	$282.00	$105.24
26055 Incision of tendon covering	19	15	$2570.00	$296.55
64721 Release and/or relocation of hand nerve	17	14	$1647.00	$428.66
25609 Treatment of 3 or more broken lower forearm bone pieces on thumb side inside wrist joint with placement of stabilizing device	14	14	$4335.00	$1114.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	114	86	$199.00	$51.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$339.07	$77.86
99231 Follow-up hospital inpatient care per day, typically 15 minutes	25	13	$117.00	$40.06
64721 Release and/or relocation of hand nerve	16	14	$1647.00	$444.35
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	14	14	$385.00	$139.71

Medical Specialties & State Licenses

CMS Verified: 2020-11-09

Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License MA 57647

A surgeon who specializes in plastic and reconstructive surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

3019721 (MA)

Hospital & Practice Group Affiliations

Umass Memorial Medical Group Inc

378 Plantation St, Worcester, MA 016052324

Phone: 5083341000

Umass Memorial Medical Group Inc

55 Lake Ave N, Worcester, MA 016550002

Phone: 5083341000

Umass Memorial Medical Group Inc

119 Belmont St, Worcester, MA 016052903

Phone: 5083341000

Umass Memorial Medical Group Inc

281 Lincoln St, Worcester, MA 016052138

Phone: 5083341000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners

Dr. John Castle , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1033193289

Doctor of Medicine (M.D.)

Dr. Stephanie Preston , MD

Surgery - Surgery of the Hand

NPI 1033643259

Doctor of Medicine (M.D.)

Sarah Wyllie , PA-C

Physician Assistant

NPI 1174078059

Physician Assistant (Certified)

Dr. Raymond Dunn , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1225012347

Doctor of Medicine (M.D.)

Dr. Mustafa Akyurek , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1275523623

Doctor of Medicine (M.D.)

Sarah Berthiaume

Nurse Practitioner

NPI 1346949112

Career & Practice History Timeline

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

11 Historical Events

✅

NPI Profile Active November 09, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location November 09, 2017

Registered at 281 LINCOLN ST, DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, WORCESTER, MA 016052138 (Tel: 5083345958)

📍

Updated Business Mailing Address November 09, 2017

Registered at PO BOX 415348, BOSTON, MA 022410001 (Tel: 8002258885)

👤

Provider Name / Credentials Updated November 09, 2017

Recorded as DOUGLAS ROTHKOPF, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 09, 2017

Surgery (License #57647 in MA)

✅

NPI Profile Active April 06, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location April 06, 2009

Registered at 281 LINCOLN ST, DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, WORCESTER, MA 016052138 (Tel: 5083345942)

📍

Updated Business Mailing Address April 06, 2009

Registered at PO BOX 415348, BOSTON, MA 022410001 (Tel: 8002258885)

👤

Provider Name / Credentials Updated April 06, 2009

Recorded as DOUGLAS ROTHKOPF, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2009

Surgery (License #57647 in MA)

🟢

Initial NPI Registration & Enumeration December 01, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578547600

Entity Type:

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

Enumeration Date: December 01, 2005

Last Update: November 09, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 415348

Boston, MA 022410001

Phone: 8002258885

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.