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THERESA RENEE METANCHUK D.O.
NPI 1255627204
Family Medicine in West Grove, PA

Active since June 28, 2011PECOS EnrolledAccepts Medicare Assignment
78.87/100
CMS Quality Rating
455 WOODVIEW RD, SUITE 100, WEST GROVE, PA 19390(610) 345-1900(610) 345-1901 Get Directions Write a Review

NPPES record last updated: February 27, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Theresa Renee Metanchuk D.o. NPPES

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

THERESA RENEE METANCHUK D.O. (NPI 1255627204) is an individual family medicine provider in West Grove, Pennsylvania, licensed in Pennsylvania (OS016309) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS, is affiliated with Union Hospital Of Cecil County, and is a graduate of Philadelphia College Of Osteopathic Medicine (2011).

NPPES Registry Identity

NPI1255627204
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameTHERESA RENEE METANCHUKCredential: D.O.
Location Address455 WOODVIEW RD, SUITE 100West Grove, PA 19390-9303
Mailing Address455 Woodview Rd, Suite 100West Grove, PA 19390-9303 · (610) 345-1900 · Fax (610) 345-1901
Phone(610) 345-1900
Fax(610) 345-1901
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2011
Enumeration DateJune 28, 2011
Last NPPES UpdateFebruary 27, 2017
✔ NPI 1255627204 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 · OS016309
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.
455 WOODVIEW RD, West Grove, PA 19390
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Other Names 1

Former Name (1)Theresa Renee Hipp D.o.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.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

Theresa Renee Metanchuk D.o. 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 ID749409118
PECOS Enrollment IDI20230211000177
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 10

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 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.
390 services250 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.
98 services89 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
67 services67 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
61 services59 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
38 services36 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
32 services30 patients

Hospital Affiliations CMS Care Compare 2

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

Union Hospital Of Cecil County

Acute Care Hospitals · Elkton, MD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210032
Location106 Bow StreetElkton, MD 21921 · Cecil County
Birthing friendly

Chester County Hospital

Acute Care Hospitals · West Chester, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390179
Location701 East Marshall StreetWest Chester, PA 19380 · Chester County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19390 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

78.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.2
Promoting Interoperability88
Improvement Activities40
Cost57.04

Referred Medical Equipment & Supplies CMS DME claims 2

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
8 suppliers28 claims105 services$6.78 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers15 claims32 services$1.19 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 4

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

AIDAN MANLEY O'BRIEN
Physical Therapist
455 WOODVIEW RD
WEST GROVE, PA 19390
Chester County (610) 345-1950
JEANNE MARIE KELLY MD
Family Medicine
455 WOODVIEW RD, SUITE 100
WEST GROVE, PA 19390
Chester County (610) 345-1900
SKYE ALTAIRE DO
Family Medicine
455 WOODVIEW RD
WEST GROVE, PA 19390
Chester County (610) 431-5000
CHRISTINE MARIE MCKEON CRNP
Nurse Practitioner (Family)
455 WOODVIEW RD
WEST GROVE, PA 19390
Chester County (800) 789-7366

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 Theresa Metanchuk's NPI number?

The NPI number for Theresa Metanchuk is 1255627204. It was assigned to this individual provider in the NPPES registry on June 28, 2011. The provider is also known as Theresa Renee Hipp D.O..

Where is Theresa Metanchuk located?

Theresa Metanchuk practices at 455 Woodview Rd Suite 100, West Grove, PA 19390. The listed phone number is (610) 345-1900.

What is Theresa Metanchuk's specialty?

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

Is Theresa Metanchuk enrolled in Medicare?

Yes. Theresa Metanchuk 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 Theresa Metanchuk accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Theresa Metanchuk 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 Theresa Metanchuk affiliated with any hospitals?

According to CMS data, Theresa Metanchuk is affiliated with Union Hospital Of Cecil County and Chester County Hospital.

When was this NPI record last updated?

The NPPES record for Theresa Metanchuk was last updated on February 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.