KENNETH MACNEAL
NPI 1487180519
Internal Medicine in Philadelphia, PA

NPI Status: Active since May 10, 2017

Contact Information

3400 SPRUCE ST
100 CENTREX
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-2532

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Medicare Participation & PECOS Status
Physician Visit Costs
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 9
Internal Medicine
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About KENNETH MACNEAL

This page provides the complete NPI Profile along with additional information for Kenneth Macneal, an internist established in Philadelphia, Pennsylvania with a medical specialization in Internal Medicine and more than 9 years of experience. He graduated from Washington State University Elson S Floyd College Of Medicine in 2017. The healthcare provider is registered in the NPI registry with number 1487180519 assigned on May 2017. The practitioner's primary taxonomy code is 207R00000X with license number MT214093 (PA). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI: 1487180519
Provider Name: KENNETH MACNEAL
Gender: Male
Entity Type: Individual
Location Address: 3400 SPRUCE ST 100 CENTREX PHILADELPHIA, PA 19104
Location Phone: (215) 662-2532
Mailing Address: 3400 SPRUCE ST 100 CENTREX PHILADELPHIA, PA 19104
Medical School Name: WASHINGTON STATE UNIVERSITY ELSON S FLOYD COLLEGE OF MEDICINE
Graduation Year: 2017
Is Sole Proprietor?: No
Enumeration Date: 05-10-2017
Last Update Date: 11-02-2017
Code Navigator

An internist like Kenneth Macneal is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine
Taxonomy Code: 207R00000X
Type: Allopathic & Osteopathic Physicians
License No.: MT214093
License State: PA
Taxonomy Description: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	208000000X	Allopathic & Osteopathic Physicians	Pediatrics	MT214093 (PA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Blue Cross Blue Shield of North Dakota

BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) - PPO
BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) - PPO
BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
BlueEssential Catastrophic 100 $9200 Deductible - PPO
BlueValue Bronze $50 PCP Copay (Standardized plan) - PPO
BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Kenneth Macneal is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kenneth Macneal is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 4880044056
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20231229002398
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $34.29 for a new patient copayment and $26.3 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 19104 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $137.17
Minimum New Patient Price $59.88
Maximum New Patient Price $180.99

Average New Patient Copayment $34.29
Minimum New Patient Copayment $14.97
Maximum New Patient Copayment $45.24

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $105.21
Minimum Established Patient Price $19.3
Maximum Established Patient Price $147.29

Average Established Patient Copayment $26.3
Minimum Established Patient Copayment $4.82
Maximum Established Patient Copayment $36.82

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	4	8	7	1	8	0	5	1	9
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	4	16	7	2	8	0	5	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 6 + 7 + 2 + 8 + 0 + 5 + 2 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 9									9

The NPI number 1487180519 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

DR. HARRY BART SMELTZ DO

Anesthesiology

3400 SPRUCE ST
6 DULLES
PHILADELPHIA, PA
ZIP 19104

About KENNETH MACNEAL

Location Map

Specialty - Primary Taxonomy

Internal Medicine

Secondary Taxonomies

Pediatrics

Insurance Plans Accepted

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 4880044056

PECOS Enrollment ID: I20231229002398

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Reviews for KENNETH MACNEAL

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions