JOHN RAFFENSPERGER
NPI 1396710869
Specialist in Pittsburgh, PA

Active since February 20, 2006PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
200 DELAFIELD RD, SUITE 2040, PITTSBURGH, PA 15215(412) 782-5529 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About John Raffensperger NPPES

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

JOHN RAFFENSPERGER (NPI 1396710869) is an individual specialist in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD038748E) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Upmc St Margaret, and is a graduate of University Of Pittsburgh School Of Medicine (1985).

NPPES Registry Identity

NPI1396710869
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameJOHN RAFFENSPERGER
Location Address200 DELAFIELD RD, SUITE 2040Pittsburgh, PA 15215-3205
Mailing Address200 Delafield Rd, Suite 2040Pittsburgh, PA 15215-3205
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1985
Enumeration DateFebruary 20, 2006
Last NPPES UpdateMarch 25, 2021
NPI 1396710869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in PA · MD038748E
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

200 DELAFIELD RD, Pittsburgh, PA 15215

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

John Raffensperger 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 ID4486646478
PECOS Enrollment IDI20040331000675
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
323 services106 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.
130 services92 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
84 services42 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
56 services50 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.
41 services41 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
34 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Upmc St Margaret

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390102
Location815 Freeport RoadPittsburgh, PA 15215 · 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

Upmc Presbyterian Shadyside

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390164
Location200 Lothrop StreetPittsburgh, PA 15213 · Allegheny County
Emergency services

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.

78.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.61
Promoting Interoperability100
Improvement Activities40
Cost53.82

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
10 suppliers29 claims29 services$33.75 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
11 suppliers22 claims22 services$79.78 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
10 suppliers24 claims53 services$30.78 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
8 suppliers13 claims13 services$50.17 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
11 suppliers22 claims22 services$16.24 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
6 suppliers11 claims11 services$11.99 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 20

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

Physician Assistant
200 DELAFIELD RD, SUITE 1040
PITTSBURGH, PA 15215
Orthopaedic Surgery
200 DELAFIELD RD, SUITE 1040 MEDICAL ARTS BLDG
PITTSBURGH, PA 15215
Internal Medicine (Geriatric Medicine)
200 DELAFIELD RD, SUITE 2005
PITTSBURGH, PA 15215
Physician Assistant (Medical)
200 DELAFIELD RD, 200 MEDICAL ARTS BUILDING SUITE 2040
PITTSBURGH, PA 15215
Durable Medical Equipment & Medical Supplies
200 DELAFIELD RD, SUITE 3050
PITTSBURGH, PA 15215
Specialist/Technologist, Pathology (Medical Technologist)
200 DELAFIELD RD
PITTSBURGH, PA 15215
Internal Medicine (Cardiovascular Disease)
200 DELAFIELD RD, SUITE 3010
PITTSBURGH, PA 15215
Physician Assistant (Medical)
200 DELAFIELD RD, SUITE 2040
PITTSBURGH, PA 15215

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 John Raffensperger's NPI number?

The NPI number for John Raffensperger is 1396710869. It was assigned to this individual provider in the NPPES registry on February 20, 2006.

Where is John Raffensperger located?

John Raffensperger practices at 200 Delafield Rd Suite 2040, Pittsburgh, PA 15215. The listed phone number is (412) 782-5529.

What is John Raffensperger's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is John Raffensperger enrolled in Medicare?

Yes. John Raffensperger 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 John Raffensperger affiliated with any hospitals?

According to CMS data, John Raffensperger is affiliated with Upmc St Margaret, Magee Womens Hospital Of Upmc Health System and Upmc Presbyterian Shadyside.

When was this NPI record last updated?

The NPPES record for John Raffensperger was last updated on March 25, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.