STACEY M KASSUTTO MD
NPI 1548587785
Internal Medicine - Critical Care Medicine in Philadelphia, PA

Q: What is Stacey Kassutto's NPI number?

The NPI number for Stacey Kassutto is 1548587785. It was assigned to this individual provider in the NPPES registry on April 28, 2010. The provider is also known as Stacey Michelle Blanck MD.

Q: What is Stacey Kassutto's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Kassutto was last updated on October 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since April 28, 2010PECOS EnrolledAccepts Medicare Assignment

85.48/100

CMS Quality Rating

3400 CIVIC CENTER BLVD FL 1, PHILADELPHIA, PA 19104(215) 662-3202(215) 349-8432 Get Directions Write a Review

NPPES record last updated: October 14, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 14, 2019, Nov 17, 2016, Nov 3, 2016 (3 updates tracked since 2016).

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About Stacey M Kassutto Md NPPES

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

STACEY M KASSUTTO MD (NPI 1548587785) is an individual critical care medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD447429) and active in the NPI registry since April 2010. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (2010).

NPPES Registry Identity

NPI1548587785

Entity TypeIndividualFemale

Primary Taxonomy207RC0200X

Provider Legal NameSTACEY M KASSUTTOCredential: MD

Location Address3400 CIVIC CENTER BLVD FL 1Philadelphia, PA 19104-5161

Mailing Address3400 Civic Center Blvd Fl 1Philadelphia, PA 19104-5161 · (215) 662-3202 · Fax (215) 349-8432

Phone(215) 662-3202

Fax(215) 349-8432

Sole ProprietorNo

Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 2010

Enumeration DateApril 28, 2010

Last NPPES UpdateOctober 14, 20193 updates tracked since enumeration

✔ NPI 1548587785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in PA · MD447429

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD447429 (PA)

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License MD447429 (PA)

3400 CIVIC CENTER BLVD FL 1, Philadelphia, PA 19104

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Other Names 1

Other Name (5)Stacey Michelle Blanck Md

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

Stacey M Kassutto 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 ID4284915794

PECOS Enrollment IDI20161221000565

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.

23 services17 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.

18 services11 patients

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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

Quality

73.6

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers14 claims16 services$1.24 avg. paid by Medicare

Aerosol mask, used with dme nebulizer A7015

DME-Other DME · category DE000N

1 supplier12 claims12 services$1.01 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier11 claims11 services$2.02 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

5 suppliers40 claims40 services$68.33 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers17 claims17 services$32.49 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

4 suppliers17 claims2,765 services$0.03 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 20

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

DR. DAVID MICHAEL DIBARDINO M.D.

Internal Medicine (Critical Care Medicine)