ILANA RACHSHTUT MD
NPI 1396774279
Family Medicine in Kutztown, PA

Active since July 02, 2006PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
15050 KUTZTOWN RD, KUTZTOWN, PA 19530(610) 683-7393(610) 683-5470 Get Directions Write a Review

NPPES record last updated: October 16, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 16, 2018, Feb 27, 2018 (2 updates tracked since 2018).

About Ilana Rachshtut Md NPPES

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

ILANA RACHSHTUT MD (NPI 1396774279) is an individual family medicine provider in Kutztown, Pennsylvania, licensed in Pennsylvania (MD420930) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1396774279
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameILANA RACHSHTUTCredential: MD
Location Address15050 KUTZTOWN RDKutztown, PA 19530-9275
Mailing AddressPo Box 13579Reading, PA 19612-3579
Fax(610) 683-5470
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJuly 2, 2006
Last NPPES UpdateOctober 16, 20182 updates tracked since enumeration
NPI 1396774279 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 · MD420930
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.
15050 KUTZTOWN RD, Kutztown, PA 19530

Other Identifiers 1

Medicaid001970742PA

Accepted 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

Ilana Rachshtut 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 ID3072509090
PECOS Enrollment IDI20040423000550
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 12

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.
927 services425 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.
234 services234 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.
131 services96 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.
90 services88 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
41 services38 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
36 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

St Luke's Hospital Bethlehem

Acute Care Hospitals · Bethlehem, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390049
Location801 Ostrum StreetBethlehem, PA 18015 · Northampton County
Emergency services Birthing friendly

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390096
Location2500 Bernville RoadReading, PA 19605 · Berks County
Emergency services Birthing friendly

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390133
Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19530 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
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.

81.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.56
Promoting Interoperability97
Improvement Activities40
Cost65.23

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…
18%681 patients1/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
16%108 patients1/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 45 patients
100%63 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 10

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
19 suppliers104 claims278 services$6.08 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
14 suppliers49 claims55 services$1.05 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers11 claims11 services$86.43 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers12 claims32 services$32.70 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers39 claims39 services$17.16 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier20 claims20 services$3.97 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 6

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

Clinic/Center (Physical Therapy)
15050 KUTZTOWN RD
KUTZTOWN, PA 19530
Physical Therapist
15050 KUTZTOWN RD
KUTZTOWN, PA 19530
Physician Assistant
15050 KUTZTOWN RD
KUTZTOWN, PA 19530
Specialist
15050 KUTZTOWN RD
KUTZTOWN, PA 19530
Physical Therapist
15050 KUTZTOWN RD
KUTZTOWN, PA 19530
Family Medicine (Geriatric Medicine)
15050 KUTZTOWN RD
KUTZTOWN, PA 19530

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 Ilana Rachshtut's NPI number?

The NPI number for Ilana Rachshtut is 1396774279. It was assigned to this individual provider in the NPPES registry on July 2, 2006.

Where is Ilana Rachshtut located?

Ilana Rachshtut practices at 15050 Kutztown Rd, Kutztown, PA 19530. The listed phone number is (610) 683-7393.

What is Ilana Rachshtut's specialty?

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

Is Ilana Rachshtut enrolled in Medicare?

Yes. Ilana Rachshtut 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 Ilana Rachshtut accept?

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

According to CMS data, Ilana Rachshtut is affiliated with Reading Hospital, St Luke's Hospital Bethlehem, Penn State Health St. Joseph and Lehigh Valley Hospital.

When was this NPI record last updated?

The NPPES record for Ilana Rachshtut was last updated on October 16, 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.