EDWARD BRETTHOLZ MD
NPI 1093739393
Internal Medicine - Gastroenterology in New York, NY

Q: What is Edward Brettholz's NPI number?

The NPI number for Edward Brettholz is 1093739393. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Q: What is Edward Brettholz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Edward Brettholz was last updated on January 24, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since July 27, 2006PECOS Enrolled

75/100

CMS Quality Rating

232 E 30TH ST, NEW YORK, NY 10016(212) 889-5544(212) 481-1089 Get Directions Write a Review

NPPES record last updated: January 24, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Edward Brettholz Md NPPES

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

EDWARD BRETTHOLZ MD (NPI 1093739393) is an individual gastroenterology provider in New York, New York, licensed in New York (165247) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Lenox Hill Hospital, and is a graduate of George Washington University School Of Medicine (1979).

NPPES Registry Identity

NPI1093739393

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameEDWARD BRETTHOLZCredential: MD

Location Address232 E 30TH STNew York, NY 10016-8202

Mailing Address316 E 30th St, 2nd FloorNew York, NY 10016-8366 · (212) 614-0039 · Fax (212) 253-9631

Phone(212) 889-5544

Fax(212) 481-1089

Sole ProprietorNo

Medical School CMSGeorge Washington University School Of MedicineGraduated 1979

Enumeration DateJuly 27, 2006

Last NPPES UpdateJanuary 24, 2011

✔ NPI 1093739393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NY · 165247

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

232 E 30TH ST, New York, NY 10016

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Other Identifiers 3

Medicaid01683036NY

Medicare UPINA49056NY

Medicare PIN69D781NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edward Brettholz Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830186881

PECOS Enrollment IDI20040429001411

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 13

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.

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.

201 services138 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.

195 services129 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

50 services50 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

49 services40 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

43 services43 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

38 services38 patients

Measurement of hydrogen in breath to test for stomach and bowel symptoms 91065

This test involves breathing into a bag to measure hydrogen levels in your breath. High levels can indicate issues with food digestion or absorption in your stomach or intestines. It's non-invasive, painless, and helps diagnose certain gastrointestinal conditions.

35 services29 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

32 services32 patients

Measurement of liver stiffness 91200

Measurement of liver stiffness is a non-invasive procedure that helps assess the health of your liver. It uses sound waves to detect the hardness of the liver tissue, which can indicate conditions like fibrosis or cirrhosis. It's a simple, painless test that provides valuable information about your liver's health.

30 services25 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

27 services27 patients

Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes 99421

This service involves a week-long digital assessment of your health status. It's conducted online by your healthcare provider, focusing on managing your existing health condition. The process takes 5-10 minutes of your time daily, ensuring optimal health management.

19 services15 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

17 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lenox Hill Hospital

Acute Care Hospitals · New York, NY

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330119

Location100 East 77th StreetNew York, NY 10021 · New York County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10016 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

$150.24 typical visit price

range $65.69 – $198.19

Typical copayment $37.56 (range $16.42 – $49.54)

Most-billed visit code 99204

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

54%206 patients3/55-star benchmark: 92%

Cervical Cancer Screening

Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…

59%261 patients

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

93%476 patients5/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

93%1,471 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%2,351 patients5/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

95%541 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

85%1,104 patients4/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

24%295 patients2/55-star benchmark: 90%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

69%1,104 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

58%1,104 patients3/55-star benchmark: 89%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 1% · 295 patients

2%295 patients4/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

24%1,104 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONCORDE MEDICAL GROUP,PLLC

Clinic/Center (Multi-Specialty)