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PETER A MERKEL MD, MPH
NPI 1437136173
Internal Medicine - Rheumatology in Radnor, PA

Active since December 23, 2005PECOS EnrolledAccepts Medicare Assignment
85.48/100
CMS Quality Rating
250 KING OF PRUSSIA, RADNOR, PA 19087(610) 902-5700(617) 638-5226 Get Directions Write a Review

NPPES record last updated: February 3, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Peter A Merkel Md, Mph NPPES

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

PETER A MERKEL MD, MPH (NPI 1437136173) is an individual rheumatology provider in Radnor, Pennsylvania, licensed in Pennsylvania (MD043272L) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Yale University School Of Medicine (1988).

NPPES Registry Identity

NPI1437136173
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NamePETER A MERKELCredential: MD, MPH
Location Address250 KING OF PRUSSIARadnor, PA 19087-5220
Mailing Address250 King Of PrussiaRadnor, PA 19087-5220 · (610) 902-5700 · Fax (617) 414-6031
Phone(610) 902-5700
Fax(617) 638-5226
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 1988
Enumeration DateDecember 23, 2005
Last NPPES UpdateFebruary 3, 2012
✔ NPI 1437136173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
Licenses✔ Licensed in PA · MD043272L✔ Licensed in MA · 75719
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.
Also ListedInternal MedicineTaxonomy 207R00000X · License 75719 (MA)
250 KING OF PRUSSIA, Radnor, PA 19087
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINE79559MA
Medicare ID-Type UnspecifiedJ31010MA
Medicaid3134431MA

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

Peter A Merkel Md, Mph 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 ID9830135292
PECOS Enrollment IDI20120123000561
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 2

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.
45 services31 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.
15 services12 patients

Hospital Affiliations CMS Care Compare 2

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

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19087 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

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 Peter Merkel's NPI number?

The NPI number for Peter Merkel is 1437136173. It was assigned to this individual provider in the NPPES registry on December 23, 2005.

Where is Peter Merkel located?

Peter Merkel practices at 250 King Of Prussia, Radnor, PA 19087. The listed phone number is (610) 902-5700.

What is Peter Merkel's specialty?

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

Is Peter Merkel enrolled in Medicare?

Yes. Peter Merkel 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 Peter Merkel accept?

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

According to CMS data, Peter Merkel is affiliated with Hospital Of Univ Of Pennsylvania and Penn Presbyterian Medical Center.

When was this NPI record last updated?

The NPPES record for Peter Merkel was last updated on February 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.