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ETHAN CRAIG MD
NPI 1316239874
Internal Medicine - Rheumatology in Philadelphia, PA

Active since May 03, 2011PECOS EnrolledAccepts Medicare Assignment
85.48/100
CMS Quality Rating
3400 SPRUCE ST, 5 WHITE, PHILADELPHIA, PA 19104(215) 662-2454(215) 662-7527 Get Directions Write a Review

NPPES record last updated: August 13, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Craig Md NPPES

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

ETHAN CRAIG MD (NPI 1316239874) is an individual rheumatology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD464131) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Pennsylvania State University College Of Medicine (2011).

NPPES Registry Identity

NPI1316239874
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameETHAN CRAIGCredential: MD
Location Address3400 SPRUCE ST, 5 WHITEPhiladelphia, PA 19104
Mailing Address3400 Spruce St, 5 WhitePhiladelphia, PA 19104-4238 · (215) 662-2454 · Fax (215) 662-7527
Phone(215) 662-2454
Fax(215) 662-7527
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 2011
Enumeration DateMay 3, 2011
Last NPPES UpdateAugust 13, 2018
✔ NPI 1316239874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in PA · MD464131
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
3400 SPRUCE ST, Philadelphia, PA 19104
Open in Google Maps ↗

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

Ethan Craig Md 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 ID3274765243
PECOS Enrollment IDI20180906000027
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 3

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.
38 services29 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
24 services21 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
16 services16 patients

Hospital Affiliations CMS Care Compare 4

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services 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

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390223
Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County
Emergency services

Pennsylvania Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390226
Location800 Spruce StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
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.

85.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.6
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

ELIZABETH FOGLIA MD
Pediatrics
3400 SPRUCE ST, 8 RAVDIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3228
JOEL M STEIN MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3005
PRISCILLA NELSON M.D.
Anesthesiology
3400 SPRUCE ST, 6 DULLES
PHILADELPHIA, PA 19104
Philadelphia County (215) 349-8310
DR. JASON THOMAS ACKRIVO MD
Internal Medicine (Pulmonary Disease)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 614-0871
JEAN-PHILIPPE RICHARD DMD
Student in an Organized Health Care Education/Training Program
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-6176
LEAH M LOPEZ PA-C
Physician Assistant (Medical)
3400 SPRUCE ST, 4 SILVERSTEIN
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-7870
MONIQUE LORRAINE ROBERTS SALAHUB
Anesthesiology (Critical Care Medicine)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-4000
JOANIE M GARRATT MD
Radiology (Diagnostic Radiology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Philadelphia County (215) 662-3000

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 Ethan Craig's NPI number?

The NPI number for Ethan Craig is 1316239874. It was assigned to this individual provider in the NPPES registry on May 3, 2011.

Where is Ethan Craig located?

Ethan Craig practices at 3400 Spruce St 5 White, Philadelphia, PA 19104. The listed phone number is (215) 662-2454.

What is Ethan Craig's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Ethan Craig enrolled in Medicare?

Yes. Ethan Craig 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 Ethan Craig accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Ethan Craig 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 Ethan Craig affiliated with any hospitals?

According to CMS data, Ethan Craig is affiliated with Hospital Of Univ Of Pennsylvania, Chester County Hospital, Penn Presbyterian Medical Center and Pennsylvania Hospital.

When was this NPI record last updated?

The NPPES record for Ethan Craig was last updated on August 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.