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DR. PRABHAT SETH M.D.
NPI 1356383277
Internal Medicine in Mckeesport, PA

Active since June 12, 2006PECOS EnrolledAccepts Medicare Assignment
96.66/100
CMS Quality Rating
1430 LINCOLN WAY, MCKEESPORT, PA 15131(412) 678-0219(412) 678-0764 Get Directions Write a Review

NPPES record last updated: February 25, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Prabhat Seth M.d. NPPES

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

DR. PRABHAT SETH M.D. (NPI 1356383277) is an individual internal medicine provider in Mckeesport, Pennsylvania, licensed in Pennsylvania (MD037071L) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Upmc Mckeesport Hospital, and is a graduate of Other (1971).

NPPES Registry Identity

NPI1356383277
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PRABHAT SETHCredential: M.D.
Location Address1430 LINCOLN WAYMckeesport, PA 15131-1606
Mailing Address1430 Lincoln WayMckeesport, PA 15131-1606 · (412) 678-0219 · Fax (412) 678-0764
Phone(412) 678-0219
Fax(412) 678-0764
Sole ProprietorYes
Medical School CMSOtherGraduated 1971
Enumeration DateJune 12, 2006
Last NPPES UpdateFebruary 25, 2016
✔ NPI 1356383277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD037071L
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1430 LINCOLN WAY, Mckeesport, PA 15131
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Other Identifiers 2

Medicare UPINC28251PA
Medicare ID-Type Unspecified034338PA

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

Dr. Prabhat Seth 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 ID6103916051
PECOS Enrollment IDI20071217000260
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 6

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.
467 services95 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
168 services84 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
85 services74 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.
66 services66 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
63 services63 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
16 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Upmc Mckeesport Hospital

Acute Care Hospitals · Mc Keesport, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390002
Location1500 Fifth AvenueMc Keesport, PA 15132 · Allegheny County
Emergency services

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390114
Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County
Emergency services Birthing friendly

Forbes Hospital

Acute Care Hospitals · Monroeville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390267
Location2570 Haymaker RoadMonroeville, PA 15146 · Allegheny County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15131 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.

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.

96.66/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality98.96
Improvement Activities40
Cost90.27

Reported Quality Measures

Breast Cancer Screening
70%184 patients4/55-star benchmark: 93%
Cervical Cancer Screening
19%153 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
66%441 patients4/55-star benchmark: 88%
Controlling High Blood Pressure
55%451 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
22%124 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
13%124 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%3,973 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
29%401 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
32%760 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
47%615 patients2/55-star benchmark: 97%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 422 patients
Patients totalRate: 0% · 422 patients
0%422 patients5/55-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 5

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 suppliers27 claims56 services$5.36 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims12 services$0.85 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
4 suppliers12 claims72 services$1.53 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier11 claims11 services$28.78 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$185.12 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.

PRABHAT SETH MD LLC
Internal Medicine
1430 LINCOLN WAY
WHITE OAK, PA 15131
Allegheny County (412) 678-0219
SETH SERVICES MANAGEMENT
Internal Medicine
1430 LINCOLN WAY
WHITE OAK, PA 15131
Allegheny County (412) 678-0219
L. T. RITCHIE, M.D., LTD
General Practice
1430 LINCOLN WAY
WHITE OAK, PA 15131
Allegheny County (412) 678-6565
PRABHAT SETH MD LLC
Internal Medicine (Adolescent Medicine)
1430 LINCOLN WAY
WHITE OAK, PA 15131
Allegheny County (412) 678-0219

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 Prabhat Seth's NPI number?

The NPI number for Prabhat Seth is 1356383277. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Prabhat Seth located?

Prabhat Seth practices at 1430 Lincoln Way, Mckeesport, PA 15131. The listed phone number is (412) 678-0219.

What is Prabhat Seth's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prabhat Seth enrolled in Medicare?

Yes. Prabhat Seth 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.

Is Prabhat Seth affiliated with any hospitals?

According to CMS data, Prabhat Seth is affiliated with Upmc Mckeesport Hospital, Magee Womens Hospital Of Upmc Health System and Forbes Hospital.

When was this NPI record last updated?

The NPPES record for Prabhat Seth was last updated on February 25, 2016. 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.