PHILIP ELBAUM
NPI 1235484031
Internal Medicine - Gastroenterology in Wyomissing, PA

Q: What is Philip Elbaum's NPI number?

The NPI number for Philip Elbaum is 1235484031. It was assigned to this individual provider in the NPPES registry on July 17, 2012.

Q: What is Philip Elbaum'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 Philip Elbaum was last updated on January 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 17, 2012PECOS EnrolledAccepts Medicare Assignment

1011 REED AVE STE 300, WYOMISSING, PA 19610(610) 374-4401(610) 374-7916 Get Directions Write a Review

NPPES record last updated: January 29, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Philip Elbaum NPPES

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

PHILIP ELBAUM (NPI 1235484031) is an individual gastroenterology provider in Wyomissing, Pennsylvania, licensed in Pennsylvania (OS016401) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2010).

NPPES Registry Identity

NPI1235484031

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NamePHILIP ELBAUM

Location Address1011 REED AVE STE 300Wyomissing, PA 19610-2002

Mailing Address1011 Reed Ave Ste 300Wyomissing, PA 19610-2002 · (610) 374-4401 · Fax (610) 374-7916

Phone(610) 374-4401

Fax(610) 374-7916

Sole ProprietorNo

Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2010

Enumeration DateJuly 17, 2012

Last NPPES UpdateJanuary 29, 2018

✔ NPI 1235484031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in PA · OS016401

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License OS016401 (PA)

1011 REED AVE STE 300, Wyomissing, PA 19610

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Other Identifiers 1

Medicaid1029342510002PA

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Philip Elbaum 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 ID4385860642

PECOS Enrollment IDI20140722001206

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.

Medicare Billing Reassignment

Medicare enrollment records show Philip Elbaum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regional Gastroenterology Associates Of Lancaster, Ltd.

28 mi

Gastroenterology

2112 HARRISBURG PIKE STE 202
Lancaster, PA 17601

Reassigned Medicare billing, Pennsylvania enrollment
343 clinicians in this Medicare group

NPI 1154422806 (717) 869-4600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 15

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.

Injection, vedolizumab, intravenous, 1 mg J3380

Vedolizumab is a medication given via injection. It's used to treat certain bowel conditions (such as Crohn's disease, ulcerative colitis) by reducing inflammation. It works by blocking a certain protein that causes this inflammation.

5,100 services12 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

84 services82 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.

76 services76 patients

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.

71 services65 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.

59 services59 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

45 services45 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

43 services39 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.

43 services43 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

42 services42 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.

37 services32 patients

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.

25 services24 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.

24 services24 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

20 services15 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.

18 services18 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

18 services18 patients

Hospital Affiliations CMS Care Compare 3

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

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks County

Emergency services Birthing friendly

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390096

Location2500 Bernville RoadReading, PA 19605 · Berks County

Emergency services Birthing friendly

Milton S Hershey Medical Center

Acute Care Hospitals · Hershey, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390256

Location500 University DriveHershey, PA 17033 · Dauphin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19610 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 6

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

ABBY CATHERINE RATHMAN PA-C

Physician Assistant (Medical)