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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: October 18, 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 Upmc St Margaret, 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
Phone(412) 647-2345
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
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Benjamin Plotz reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Pittsburgh Physicians
0.1 mi
Internal Medicine
3500 5TH AVE, 4TH FLOOR
Pittsburgh, PA 15213
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7,114 clinicians in this Medicare group
NPI 1548433527 (412) 682-2434
Whc Emerg Phys
188 mi
Emergency Medical Services
110 IRVING ST NW
Washington, DC 20010
  • Reassigned Medicare billing, District of Columbia enrollment
  • Medicare enrollment name: Whc Physician Group LLC
  • 613 clinicians in this Medicare group
NPI 1306260625 (703) 558-1544

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 4

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

Upmc Passavant

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390107
Location9100 Babcock BoulevardPittsburgh, PA 15237 · 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

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.

DR. DANIELLA MUALLEM SCHWARTZ MD
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700
NIVEDITHA MOHAN
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B, SUITE 2B FALK MEDICAL BUILDING
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700
DR. VLADIMIR M LIARSKI MD, MSC
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700
LEIGH FRENO
Nurse Practitioner (Family)
3601 5TH AVE STE 2B, SUITE 2B FALK MEDICAL BUILDING
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700
DR. ALSAYED OSMAN MD
Student in an Organized Health Care Education/Training Program
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 647-5815
DR. ANTHONY JOHN NICOLAS M.D.
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 605-3924
RACHAEL ANNE GORDON MD, PHD
Internal Medicine (Rheumatology)
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700
PETA-GAY AMIKA RICKETTS DO
Internal Medicine
3601 5TH AVE STE 2B
PITTSBURGH, PA 15213
Allegheny County (412) 647-6700

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.

Which organizations bill Medicare for Benjamin Plotz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Plotz reassigns Medicare benefits to 2 organizations: University Of Pittsburgh Physicians (Pittsburgh, PA) and Whc Emerg Phys (Washington, DC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Benjamin Plotz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Benjamin Plotz affiliated with any hospitals?

According to CMS data, Benjamin Plotz is affiliated with Upmc St Margaret, Upmc Passavant, 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 2 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.