BENJAMIN HERBERT PLOTZ M.D.
NPI 1467806695
Internal Medicine - Rheumatology in Pittsburgh, PA

Active since April 13, 2016PECOS EnrolledAccepts Medicare Assignment
95.99/100
CMS Quality Rating
3601 5TH AVE STE 2B, PITTSBURGH, PA 15213(412) 647-2345 Get Directions Write a Review

NPPES record last updated: August 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 9, 2024, Jul 19, 2024, Jun 15, 2023 and 1 more (4 updates tracked since 2019).

About Benjamin Herbert Plotz M.d. NPPES

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

BENJAMIN HERBERT PLOTZ M.D. (NPI 1467806695) is an individual rheumatology provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD485469) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Magee Womens Hospital Of Upmc Health System, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1467806695
Entity TypeIndividualMale
Primary Taxonomy207RR0500X
Provider Legal NameBENJAMIN HERBERT PLOTZCredential: M.D.
Location Address3601 5TH AVE STE 2BPittsburgh, PA 15213-3403
Mailing Address3601 5th Ave Ste 2bPittsburgh, PA 15213-3403
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 13, 2016
Last NPPES UpdateAugust 9, 20244 updates tracked since enumeration
NPPES CertifiedJuly 19, 2024
NPI 1467806695 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 · MD485469 Licensed in DC · MD049262
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 298358 (NY)
3601 5TH AVE STE 2B, Pittsburgh, PA 15213

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

Benjamin Herbert Plotz 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 ID6406189281
PECOS Enrollment IDI20240808001269
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 5

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.
70 services66 patients
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.
30 services18 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.
24 services24 patients
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.
15 services15 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15213 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.

95.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.48
Promoting Interoperability100
Improvement Activities40
Cost74.87

Other Providers at the Same Location NPPES 8

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

Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B, SUITE 2B FALK MEDICAL BUILDING
PITTSBURGH, PA 15213
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Nurse Practitioner (Family)
3601 5TH AVE STE 2B, SUITE 2B FALK MEDICAL BUILDING
PITTSBURGH, PA 15213
Student in an Organized Health Care Education/Training Program
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Internal Medicine
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213

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 Benjamin Plotz's NPI number?

The NPI number for Benjamin Plotz is 1467806695. It was assigned to this individual provider in the NPPES registry on April 13, 2016.

Where is Benjamin Plotz located?

Benjamin Plotz practices at 3601 5th Ave Ste 2B, Pittsburgh, PA 15213. The listed phone number is (412) 647-2345.

What is Benjamin Plotz's specialty?

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

Is Benjamin Plotz enrolled in Medicare?

Yes. Benjamin Plotz 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 Benjamin Plotz affiliated with any hospitals?

According to CMS data, Benjamin Plotz is affiliated with Magee Womens Hospital Of Upmc Health System and Upmc Presbyterian Shadyside.

When was this NPI record last updated?

The NPPES record for Benjamin Plotz was last updated on August 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.