Dr. Marc A Theroux , MD
Internal Medicine • Fall River, MA
534 Prospect St
Fall River, MA 027205239
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Dr. Marc Theroux is listed in NPPES under Internal Medicine.
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NPI assigned on October 4, 2005; this date does not establish years in practice.
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Published CMS data list 1,242 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99214 — Established patient outpatient office visit: 506 service units.
- 99490 — Chronic care management services: 431 service units.
- 99439 — Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month: 165 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 9 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 7,257 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Rosuvastatin Calcium — 431 prescription fills, including refills.
- Atorvastatin Calcium — 355 prescription fills, including refills.
- Lisinopril — 346 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 134 records in the table · Guide: How to read Medicare Part D prescriber data
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Fewer Medicare Part B services than 65% of clinicians listed under Internal Medicine in Fall River, MA (2024, 51 clinicians with data). Median for this group: 1,661. Middle half: 1,028 to 2,783.
More Medicare Part B services than 75% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,773 clinicians with data). Median for this group: 526. Middle half: 199 to 1,077.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 3,894 in 2020 to 1,242 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
534 Prospect St
Fall River, MA 027205239
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Internal Medicine: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
438 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $115,334 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $81,190 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
30-day fills
16,091 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$343,526 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2019–2025.
NPI first issued
2005
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.
Enrolled in Medicare (PECOS)
Dr. Theroux has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Theroux as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Fall River and Massachusetts
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Fewer Medicare Part B services than 65% of clinicians listed under Internal Medicine in Fall River, MA (2024, 51 clinicians with data). Median for this group: 1,661. Middle half: 1,028 to 2,783.
More Medicare Part B services than 75% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,773 clinicians with data). Median for this group: 526. Middle half: 199 to 1,077.
Medicare-allowed amount
A lower Medicare-allowed amount than 60% of clinicians listed under Internal Medicine in Fall River, MA (2024, 51 clinicians with data). Median for this group: $146,050. Middle half: $89,925 to $233,582.
A higher Medicare-allowed amount than 80% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,773 clinicians with data). Median for this group: $50,301. Middle half: $19,690 to $96,604.
Paid by Medicare
A lower Medicare payment amount than 70% of clinicians listed under Internal Medicine in Fall River, MA (2024, 51 clinicians with data). Median for this group: $112,031. Middle half: $73,122 to $175,940.
A higher Medicare payment amount than 75% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,773 clinicians with data). Median for this group: $38,367. Middle half: $14,848 to $75,032.
Medicare Part D prescriptions
Close to the middle for clinicians listed under Internal Medicine in Fall River, MA (2024, 50 clinicians with data). Median for this group: 4,762. Middle half: 1,285 to 12,804.
More Part D prescriptions than 90% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,673 clinicians with data). Median for this group: 1,163. Middle half: 127 to 3,739.
Part D drug cost
Close to the middle for clinicians listed under Internal Medicine in Fall River, MA (2024, 50 clinicians with data). Median for this group: $331,649. Middle half: $95,540 to $681,487.
A higher Part D drug cost than 75% of clinicians listed under Internal Medicine in Massachusetts (2024, 3,673 clinicians with data). Median for this group: $101,447. Middle half: $8,909 to $319,514.
63 active clinicians are listed under Internal Medicine with a practice address in Fall River, MA (6,822 in Massachusetts).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Fall River
42.9% of these 63 clinicians have the CMS telehealth indicator.
73% of these 63 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 68% from 3,894 in 2020 to 1,242 in 2024.
- 2020: 3,894
- 2021: 3,178
- 2022: 2,655
- 2023: 2,188
- 2024: 1,242
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Medicare-allowed amount
Medicare-allowed amount decreased 52% from $241,234 in 2020 to $115,334 in 2024.
- 2020: $241,234
- 2021: $220,305
- 2022: $216,257
- 2023: $178,257
- 2024: $115,334
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Paid by Medicare
Paid by Medicare decreased 53% from $171,157 in 2020 to $81,190 in 2024.
- 2020: $171,157
- 2021: $152,736
- 2022: $154,513
- 2023: $127,338
- 2024: $81,190
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Medicare Part D prescriptions
Medicare Part D prescriptions decreased 29% from 10,235 in 2020 to 7,257 in 2024.
- 2020: 10,235
- 2021: 10,437
- 2022: 9,612
- 2023: 7,314
- 2024: 7,257
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30-day fills
30-day fills decreased 29% from 22,796 in 2020 to 16,091 in 2024.
- 2020: 22,796
- 2021: 23,059
- 2022: 20,815
- 2023: 15,739
- 2024: 16,091
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Part D drug cost
Part D drug cost decreased 32% from $507,520 in 2020 to $343,526 in 2024.
- 2020: $507,520
- 2021: $574,800
- 2022: $522,076
- 2023: $456,684
- 2024: $343,526
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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506 | 391 | $392.06 | $136.11 |
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99490
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
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431 | 68 | $195.06 | $66.59 |
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99439
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month
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165 | 46 | $147.24 | $50.68 |
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G0180
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
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33 | 31 | $171.12 | $57.97 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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25 | 25 | $278.00 | $93.85 |
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93000
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
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24 | 23 | $54.00 | $15.26 |
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G0008
Administration of influenza virus vaccine
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23 | 22 | $147.91 | $31.38 |
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99487
Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month
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19 | 16 | $407.68 | $144.40 |
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90653
Influenza vaccine, inactivated
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16 | 16 | $210.00 | $81.82 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Rosuvastatin Calcium | Rosuvastatin Calcium | 431 | 35,633 | $13,844.52 | 144 |
| Atorvastatin Calcium | Atorvastatin Calcium | 355 | 28,119 | $3,482.59 | 112 |
| Lisinopril | Lisinopril | 346 | 26,831 | $2,561.67 | 109 |
| Amlodipine Besylate | Amlodipine Besylate | 262 | 21,443 | $1,722.36 | 89 |
| Levothyroxine Sodium | Levothyroxine Sodium | 259 | 19,679 | $1,991.69 | 90 |
| Omeprazole | Omeprazole | 246 | 17,502 | $2,973.76 | 87 |
| Losartan Potassium | Losartan Potassium | 181 | 15,383 | $1,485.13 | 64 |
| Gabapentin | Gabapentin | 179 | 8,787 | $2,598.64 | 50 |
| Metoprolol Succinate | Metoprolol Succinate | 176 | 14,090 | $2,857.66 | 62 |
| Simvastatin | Simvastatin | 173 | 14,942 | $1,384.47 | 55 |
| Lorazepam | Lorazepam | 166 | 4,368 | $764.23 | 55 |
| Citalopram Hbr | Citalopram Hydrobromide | 137 | 8,705 | $682.10 | 41 |
| Furosemide | Furosemide | 135 | 8,937 | $700.39 | 52 |
| Pantoprazole Sodium | Pantoprazole Sodium | 130 | 10,181 | $1,180.21 | 46 |
| Hydrochlorothiazide | Hydrochlorothiazide | 128 | 10,484 | $737.74 | 43 |
| Alprazolam | Alprazolam | 121 | 3,871 | $1,089.36 | 35 |
| Sertraline Hcl | Sertraline Hcl | 116 | 8,728 | $1,040.28 | 37 |
| Metformin Hcl | Metformin Hcl | 113 | 9,093 | $855.94 | 39 |
| Atenolol | Atenolol | 103 | 9,107 | $921.61 | 41 |
| Eliquis | Apixaban | 102 | 4,502 | $88,055.04 | 23 |
| Tamsulosin Hcl | Tamsulosin Hcl | 99 | 7,608 | $1,825.83 | 33 |
| Fluticasone Propionate | Fluticasone Propionate | 98 | 6,135 | $1,592.93 | 41 |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 88 | 2,552 | $2,394.18 | 33 |
| Allopurinol | Allopurinol | 84 | 6,674 | $462.70 | 28 |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 78 | 1,227 | $1,409.43 | 19 |
(top 25 shown)
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2020-04-27NUCC Taxonomy Code: 207R00000X
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.
NUCC Taxonomy Code: 207R00000X
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.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - INTERNAL MEDICINE
I20050505000147
RI
5193772812
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Internal Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner
Family Nurse Practitioner (Certified)
Nurse Practitioner
Doctor of Nursing Practice, AGPCNP
Nurse Practitioner
Nurse Practitioner
Nurse Practitioner
Internal Medicine
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated October 04, 2005.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to November 2026.
NPI Administrative Meta
Other Internal Medicine Providers in Fall River
- Dr. Raju Singla, MD
- Huiling Ji
- Dr. Kate Mayans, MD
- Dr. Ehab Sorial, MD
- Dr. Muddassir Salyani, MD
- Dr. John Oconnell, MD
Mailing Address
200 Mill Rd, Ste 180
Fairhaven, MA 027195252
Phone: 5089732000