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PHILLIP JOHN STATES M.D.
NPI 1093791246
Family Medicine in Punxsutawney, PA

Active since December 20, 2005PECOS EnrolledAccepts Medicare Assignment
68.2/100
CMS Quality Rating
83 HILLCREST DR, SUITE 200, PUNXSUTAWNEY, PA 15767(814) 938-3550(814) 938-3679 Get Directions Write a Review

NPPES record last updated: October 30, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Phillip John States M.d. NPPES

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

PHILLIP JOHN STATES M.D. (NPI 1093791246) is an individual family medicine provider in Punxsutawney, Pennsylvania, licensed in Pennsylvania (MD423371) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Punxsutawney Area Hospital, and is a graduate of Temple University School Of Medicine (2001).

NPPES Registry Identity

NPI1093791246
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePHILLIP JOHN STATESCredential: M.D.
Location Address83 HILLCREST DR, SUITE 200Punxsutawney, PA 15767-2605
Mailing Address83 Hillcrest Dr, Suite 200Punxsutawney, PA 15767-2605 · (814) 938-3550 · Fax (814) 938-3679
Phone(814) 938-3550
Fax(814) 938-3679
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 2001
Enumeration DateDecember 20, 2005
Last NPPES UpdateOctober 30, 2015
✔ NPI 1093791246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · MD423371
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
83 HILLCREST DR, Punxsutawney, PA 15767
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Other Identifiers 5

Other1641714PA · Highmark Blue Shield
Medicaid1030096480002PA
Medicare PIN081510PA
Medicare UPINI12052PA
Medicaid1010451800001PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Phillip John States M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345213245
PECOS Enrollment IDI20040818000853
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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
69 services38 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
47 services45 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
47 services39 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
40 services40 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
29 services27 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
25 services14 patients

Hospital Affiliations CMS Care Compare

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

Punxsutawney Area Hospital

Acute Care Hospitals · Punxsutawney, PA
OwnershipVoluntary non-profit - Private
CMS Certification Number390199
Location81 Hillcrest DrivePunxsutawney, PA 15767 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15767 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

68.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality38.41
Improvement Activities40
Cost94.78

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
92%63 patients4/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers46 claims117 services$4.72 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers24 claims32 services$0.67 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers16 claims16 services$43.32 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers14 claims14 services$111.00 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers13 claims37 services$40.61 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers20 claims116 services$2.22 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

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

PUNXSUTAWNEY MEDICAL SERVICES
Neuromusculoskeletal Medicine & OMM
83 HILLCREST DR, SUITE 100
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-5910
FAMILY HEALTH CARE CENTER OF PUNXSUTAWNEY, INC.
Clinic/Center (Rural Health)
83 HILLCREST DR, SUITE 200
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3550
DAWN E CEKOVSKY PA-C.
Physician Assistant (Medical)
83 HILLCREST DR
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3310
DR. MAZEN HASAN MD
Urology
83 HILLCREST DR, SUITE 100
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3503
HEATHER M PARK PA-C
Physician Assistant (Medical)
83 HILLCREST DR
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3310
MRS. CECILIA ANTONIETTA GROMAN PA-C
Physician Assistant (Medical)
83 HILLCREST DR
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3310
PUNXSUTAWNEY MEDICAL ASSOCIATES, PC
Family Medicine
83 HILLCREST DR
PUNXSUTAWNEY, PA 15767
Jefferson County (814) 938-3310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip States's NPI number?

The NPI number for Phillip States is 1093791246. It was assigned to this individual provider in the NPPES registry on December 20, 2005.

Where is Phillip States located?

Phillip States practices at 83 Hillcrest Dr Suite 200, Punxsutawney, PA 15767. The listed phone number is (814) 938-3550.

What is Phillip States's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Phillip States enrolled in Medicare?

Yes. Phillip States is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Phillip States accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Phillip States as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Phillip States affiliated with any hospitals?

According to CMS data, Phillip States is affiliated with Punxsutawney Area Hospital.

When was this NPI record last updated?

The NPPES record for Phillip States was last updated on October 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.