DR. ERNEST STANLEY M.D. NPI 1215918529

Internal Medicine (Gastroenterology) in Moon Twp, PA

NPI 1215918529 Individual Male Years of Experience 36 Internal Medicine Gastroenterology PECOS Enrolled Accepts Medicare Approved Payment

About ERNEST STANLEY

Ernest Stanley is an internal medicine provider established in Moon Twp, Pennsylvania and his medical specialization is internal medicine (gastroenterology) with more than 36 years of experience. The NPI number of Ernest Stanley is 1215918529 and was assigned on November 2005. The practitioner's primary taxonomy code is 207RG0100X with license number MD055555L (PA). The provider is registered as an individual and his NPI record was last updated 12 years ago.

An internist like Dr. Ernest Stanley M.d. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Ernest Stanley is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Ernest Stanley is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with Heritage Valley Sewickley, Heritage Valley Kennedy and Heritage Valley Beaver.

The typical physician office visit costs for Medicare beneficiaries in this area are: $32.93 for a new patient copayment and $25.4 for an established patient copayment.

NPI

1215918529

Provider NameDR. ERNEST STANLEY M.D.
Provider Location Address725 CHERRINGTON PKWY SUITE 100 MOON TWP, PA 15108
Provider Mailing Address725 CHERRINGTON PKWY SUITE 100 MOON TWP, PA 15108
GenderMale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1986
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date11-14-2005
Last Update Date10-02-2010


Primary Taxonomy

Taxonomy Code207RG0100X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationGastroenterology
License No.MD055555L
License StatePA
Taxonomy DescriptionAn 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.

Business Address

DR. ERNEST STANLEY M.D.
725 CHERRINGTON PKWY
SUITE 100
MOON TWP, PA
ZIP 15108
Phone: (412) 262-1000
Fax: (412) 262-4607

Get Directions


Mailing Address

DR. ERNEST STANLEY M.D.
725 CHERRINGTON PKWY
SUITE 100
MOON TWP, PA
ZIP 15108
Phone: (412) 262-1000
Fax: (412) 262-4607



Medicare Participation

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

Registered in PECOS? Yes
PECOS PAC ID1052593456
PECOS Enrollment IDI20110307000410
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 15108 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99204
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$57.02 $174.05 $131.75
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$14.25 $43.51 $32.93
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$17.59 $142.08 $101.62
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.39 $35.52 $25.4

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 57Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
  • 52Biopsy of large bowel using an endoscope (HCPCS:45380)
  • 45Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • 14Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)
  • 12Diagnostic examination of large bowel using an endoscope (HCPCS:45378)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ernest Stanley is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
HERITAGE VALLEY SEWICKLEY720 BLACKBURN ROAD
SEWICKLEY, PA 15143
(412) 741-7000Acute Care Hospitals390037
HERITAGE VALLEY KENNEDY25 HECKEL ROAD
MCKEES ROCKS, PA 15136
(412) 777-6161Acute Care Hospitals390157
HERITAGE VALLEY BEAVER1000 DUTCH RIDGE ROAD
BEAVER, PA 15009
(412) 728-7000Acute Care Hospitals390036

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1007728510005MEDICAID (05)PA
753396NYBMEDICARE ID-TYPE UNSPECIFIED (04)PA
F39114MEDICARE UPIN (02)PA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1801891593 JAMES A PILLA D.O.
Individual
Internal Medicine (Gastroenterology)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000
1720070360DR. ORIENTE A DITANO MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1548252190DR. NICHOLAS J KUBIK III MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1669464293DR. JAMES A D'ANTONIO MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 261-7800
1215929740DR. JON A LEVY MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1124010665DR. STEPHEN J THOMAS MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1932191475DR. GARY L SMITH MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1619969151DR. JEFFREY B MULHOLLAND MD
Individual
Specialist725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1932181260DR. RICHARD KIM M.D.
Individual
Internal Medicine (Gastroenterology)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000
1184606410DR. LESTER STINE M.D.
Individual
Internal Medicine (Gastroenterology)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000
1881676138DR. ROBERT D FUSCO M.D.
Individual
Internal Medicine (Gastroenterology)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000
1902888050DR. FRANK KIM M.D.
Individual
Internal Medicine (Gastroenterology)725 CHERRINGTON PKWY SUITE 100
MOON TWP, PA 15108
(412) 262-1000
1649232919MRS. HEATHER L FRITZ PA-C
Individual
Physician Assistant (Surgical)725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1558323774MS. NANCY C DEBRANSKI PA-C
Individual
Physician Assistant (Surgical)725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1508828203MS. LISA CIAMACCO RN
Individual
Registered Nurse (Medical-Surgical)725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1881657641MS. DEBORAH D DAVID CST
Individual
725 CHERRINGTON PKWY STE 200
MOON TOWNSHIP, PA 15108
(412) 262-7800
1902852726MS. MARISSA ANNE NOCERA D.P.T.
Individual
Physical Therapist725 CHERRINGTON PKWY SUITE 201
MOON TOWNSHIP, PA 15108
(412) 264-6192
1336261288MRS. LISA L MASON MPT
Individual
Physical Therapist725 CHERRINGTON PKWY SUITE 201
MOON TOWNSHIP, PA 15108
(412) 264-6192
1174640445 SUSAN A. SILVER M.D.
Individual
Pathology (Anatomic Pathology)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000
1992995971 LISA ANN FADDEN CRNP
Individual
Nurse Practitioner (Family)725 CHERRINGTON PKWY SUITE 100
MOON TOWNSHIP, PA 15108
(412) 262-1000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.