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ERIN L SETZER MD
NPI 1578881165
Emergency Medicine in Morgantown, WV

Active since May 07, 2010PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506(304) 598-4000 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2025, Jul 17, 2024, Apr 8, 2022 (3 updates tracked since 2022).

About Erin L Setzer Md NPPES

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

ERIN L SETZER MD (NPI 1578881165) is an individual emergency medicine provider in Morgantown, West Virginia, licensed in West Virginia (24831) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Mon Health Medical Center, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1578881165
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameERIN L SETZERCredential: MD
Location Address1 MEDICAL CENTER DRIVEMorgantown, WV 26506
Mailing AddressPo Box 780Morgantown, WV 26507-0780 · (304) 285-7101
Phone(304) 598-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMay 7, 2010
Last NPPES UpdateSeptember 17, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
✔ NPI 1578881165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in WV · 24831
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1 MEDICAL CENTER DRIVE, Morgantown, WV 26506
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1812 Gorman AveElkins, WV 26241-3181 · Phone (304) 636-3300
Location 2140 Middletown LoopFairmont, WV 26554-8701 · Phone (304) 333-1150
Location 31200 J D Anderson DrMorgantown, WV 26505-3494 · Phone (304) 598-1200

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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

Erin L Setzer 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 ID2365687399
PECOS Enrollment IDI20130322000381
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

5

Medicare enrollment records show Erin Setzer reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

West Virginia University Medical Corporation
Same address
Family Medicine
1 MEDICAL CENTER DRIVE
Morgantown, WV 26506
  • Reassigned Medicare billing, West Virginia enrollment
  • 2,471 clinicians in this Medicare group
NPI 1275504508 (304) 598-4800
Monongalia County General Hospital Company
0.7 mi
Emergency Medicine
1200 J D ANDERSON DR
Morgantown, WV 26505
  • Reassigned Medicare billing, West Virginia enrollment
  • 318 clinicians in this Medicare group
NPI 1477890440 (304) 598-1200
Mon Health Marion Neighborhood Hospital, Inc.
19 mi
Hospitalist
140 MIDDLETOWN LOOP
White Hall, WV 26554
  • Reassigned Medicare billing, West Virginia enrollment
  • 70 clinicians in this Medicare group
NPI 1417521337 (304) 333-1150
Davis Memorial Hospital
50 mi
General Acute Care Hospital
812 GORMAN AVE
Elkins, WV 26241
  • Reassigned Medicare billing, West Virginia enrollment
  • 246 clinicians in this Medicare group
NPI 1619964806 (304) 636-3300
Potomac Valley Hospital Of W VA , Inc
54 mi
Critical Access
100 PIN OAK LN
Keyser, WV 26726
  • Reassigned Medicare billing, West Virginia enrollment
  • Also billed through NPI 1316054919 (West Virginia)
  • 158 clinicians in this Medicare group
NPI 1912979873 (304) 597-3525

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 6

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
196 services182 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
148 services142 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
120 services116 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
65 services65 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
29 services28 patients
Emergency department visit with straightforward medical decision making 99282
An emergency department visit for a mild to moderate issue is when you seek immediate medical attention for a non-life-threatening condition. This could include minor injuries, moderate pain, or illnesses like the flu. During the visit, healthcare professionals assess your condition, provide treatment, and may recommend follow-up care.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

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

Mon Health Medical Center

Acute Care Hospitals · Morgantown, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510024
Location1200 Jd Anderson DriveMorgantown, WV 26505 · Monongalia County
Emergency services Birthing friendly

Mon Health Marion

Acute Care Hospitals · Whitehall, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number510093
Location140 Middletown LoopWhitehall, WV 26554 · Marion County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26506 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

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. DORIAN J WILLIAMS M.D.
Family Medicine
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 598-6900
MEGHAN METCALFE PT
Physical Therapist
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 598-4118
MRS. HOLLY BETH HARTMAN-ADAMS M.D.
Family Medicine
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 598-6900
DR. SWAPNA GAYAM M.D
Internal Medicine (Gastroenterology)
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 293-4123
DR. JAMES ROBERT WELTY M.D.
Hospitalist
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 598-4000
ANDREW VUCELIK MD
Emergency Medicine
1 MEDICAL CENTER DRIVE, ROOM 4601
MORGANTOWN, WV 26506
Monongalia County (304) 293-7215
RYAN CODDINGTON TURNER M.D., PH.D.
Neurological Surgery
1 MEDICAL CENTER DRIVE, ROOM 4300
MORGANTOWN, WV 26506
Monongalia County (304) 293-5041
PENNY CULLEY RN
Nurse Practitioner (Family)
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Monongalia County (304) 598-4800

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 Erin Setzer's NPI number?

The NPI number for Erin Setzer is 1578881165. It was assigned to this individual provider in the NPPES registry on May 7, 2010.

Where is Erin Setzer located?

Erin Setzer practices at 1 Medical Center Drive, Morgantown, WV 26506. The listed phone number is (304) 598-4000.

What is Erin Setzer's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Erin Setzer enrolled in Medicare?

Yes. Erin Setzer 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 Erin Setzer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Erin Setzer reassigns Medicare benefits to 5 organizations: West Virginia University Medical Corporation (Morgantown, WV), Monongalia County General Hospital Company (Morgantown, WV), Mon Health Marion Neighborhood Hospital, Inc. (White Hall, WV), Davis Memorial Hospital (Elkins, WV) and Potomac Valley Hospital Of W VA , Inc (Keyser, WV). 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 Erin Setzer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Erin Setzer accept?

Health plans from CareSource list Erin Setzer 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 Erin Setzer affiliated with any hospitals?

According to CMS data, Erin Setzer is affiliated with Mon Health Medical Center and Mon Health Marion.

When was this NPI record last updated?

The NPPES record for Erin Setzer was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.