DR. PAUL STELMACH M.D.
NPI 1396765384
Internal Medicine - Pulmonary Disease in Wyomissing, PA

Q: What is Paul Stelmach's NPI number?

The NPI number for Paul Stelmach is 1396765384. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Q: What is Paul Stelmach's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

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

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment

95.64/100

CMS Quality Rating

2608 KEISER BLVD, WYOMISSING, PA 19610(610) 929-5864(610) 929-1528 Get Directions Write a Review

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

Record update history: Mar 25, 2021, Feb 10, 2021 (2 updates tracked since 2021).

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About Dr. Paul Stelmach M.d. NPPES

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

DR. PAUL STELMACH M.D. (NPI 1396765384) is an individual pulmonary disease provider in Wyomissing, Pennsylvania, licensed in Pennsylvania (MD033174E) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Penn State Health Lancaster Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1396765384

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. PAUL STELMACHCredential: M.D.

Location Address2608 KEISER BLVDWyomissing, PA 19610-3333

Mailing Address2608 Keiser BlvdWyomissing, PA 19610-3333 · (610) 929-5864 · Fax (610) 929-1528

Phone(610) 929-5864

Fax(610) 929-1528

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 1983

Enumeration DateJuly 20, 2006

Last NPPES UpdateMarch 25, 20212 updates tracked since enumeration

NPPES CertifiedMarch 25, 2021

✔ NPI 1396765384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in PA · MD033174E

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License MD033174E (PA)

2608 KEISER BLVD, Wyomissing, PA 19610

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Secondary Practice Locations 2

Location 11011 W Baltimore PikeWest Grove, PA 19390-9446 · Phone (106) 855-8646 · Fax (610) 929-1528

Location 213 Armand Hammer Blvd, Ste 300Pottstown, PA 19464-5067 · Phone (610) 685-5864 · Fax (610) 929-1528

Other Identifiers 1

Medicaid0013972330001PA

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. Paul Stelmach 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 ID6204880867

PECOS Enrollment IDI20100310000415

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

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 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.

26 services13 patients

Hospital Affiliations CMS Care Compare

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

Penn State Health Lancaster Medical Center

Acute Care Hospitals · Lancaster, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number390339

Location2160 State RoadLancaster, PA 17601 · Lancaster 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.

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.

95.64/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.57

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

72%474 patients3/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

90%1,927 patients4/55-star benchmark: 100%

Patient-Generated Health Data

Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.

30%81 patients

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

16%813 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

99%266 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%292 patients5/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

58%813 patients3/55-star benchmark: 100%

Request/Accept Summary of Care

For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…

32%65 patients2/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in…

6%813 patients1/55-star benchmark: 75%

View, Download and Transmit (VDT)

During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.

6%813 patients

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 24

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