GAETANO CAPONE MD
NPI 1669437604
Internal Medicine - Cardiovascular Disease in Philadelphia, PA

Q: What is Gaetano Capone's NPI number?

The NPI number for Gaetano Capone is 1669437604. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Q: What is Gaetano Capone's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Gaetano Capone was last updated on February 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 20, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3998 RED LION RD, SUITE 306, PHILADELPHIA, PA 19114(215) 281-0800(215) 281-2725 Get Directions Write a Review

NPPES record last updated: February 5, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Gaetano Capone Md NPPES

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

GAETANO CAPONE MD (NPI 1669437604) is an individual cardiovascular disease provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD023698E) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Jefferson Health- Northeast, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1979).

NPPES Registry Identity

NPI1669437604

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameGAETANO CAPONECredential: MD

Location Address3998 RED LION RD, SUITE 306Philadelphia, PA 19114-1445

Mailing Address3998 Red Lion Rd, Suite 306Philadelphia, PA 19114-1445 · (215) 281-0800 · Fax (215) 281-2725

Phone(215) 281-0800

Fax(215) 281-2725

Sole ProprietorNo

Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1979

Enumeration DateApril 20, 2006

Last NPPES UpdateFebruary 5, 2013

✔ NPI 1669437604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in PA · MD023698E

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

3998 RED LION RD, Philadelphia, PA 19114

Open in Google Maps ↗

Other Identifiers 3

Medicare ID-Type Unspecified194900

Medicaid000947024PA

Medicare UPINB34423

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gaetano Capone 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 ID4082516893

PECOS Enrollment IDI20051103000222

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 Reassignment

Medicare enrollment records show Gaetano Capone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Greater Philadelphia Cardiology Assc Inc

Same address

Specialist

3998 RED LION RD, SUITE 306
Philadelphia, PA 19114

Reassigned Medicare billing, Pennsylvania enrollment
7 clinicians in this Medicare group

NPI 1568516243 (215) 880-7090

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 15

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 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

444 services289 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

396 services346 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

275 services205 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

219 services212 patients

Ultrasound of leg arteries or artery grafts 93925

An ultrasound of leg arteries or artery grafts is a non-invasive imaging test. It uses high-frequency sound waves to capture live images from inside your body, specifically your leg arteries or grafts. This helps in detecting any blockages or abnormalities.

150 services148 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.

96 services76 patients

Ultrasound study of arm or leg veins with compression and maneuvers 93970

An ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.

75 services73 patients

Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts 93978

This procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.

52 services52 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days 93244

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

42 services41 patients

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days 93242

This procedure involves wearing a device, an external EKG, for up to 7 days to continuously monitor your heart rhythm. It helps detect irregularities that may not occur during a standard EKG. The device is non-invasive and safe.

41 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

38 services38 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.

30 services30 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

25 services25 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

25 services25 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

22 services21 patients

Hospital Affiliations CMS Care Compare

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

Jefferson Health- Northeast

Acute Care Hospitals · Philadelphia, PA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390115

Location10800 Knights RoadPhiladelphia, PA 19114 · Philadelphia County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19114 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

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

Most-billed visit code 99213

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

91.79

Improvement Activities

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.

AARON OPHER SHILOH M.D.

Radiology (Vascular & Interventional Radiology)

3998 RED LION RD
PHILADELPHIA, PA 19114

Philadelphia County (952) 595-1100

DEBORAH SCHILLER SCHRAGER MD

Obstetrics & Gynecology

3998 RED LION RD, SUITE 106
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4143

MELISSA A. MALLOY CRNA

Nurse Anesthetist, Certified Registered

3998 RED LION RD
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4088

DR. MIMI H PINTO DO

Radiology (Diagnostic Radiology)

3998 RED LION RD
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4021

JOHN P. SORRENTINO M.D.

Emergency Medicine

3998 RED LION RD
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4963

JUDITH KUNKLE CRNP

Registered Nurse (Emergency)

3998 RED LION RD, EMERGENCY ROOM
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4000

JOAQUIN SARIEGO MD

Surgery

3998 RED LION RD, SUITE 301
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4884

FRANKFORD TORRESDALE HOSPITAL

General Acute Care Hospital

3998 RED LION RD
PHILADELPHIA, PA 19114

Philadelphia County (215) 612-4000

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 Gaetano Capone's NPI number?

The NPI number for Gaetano Capone is 1669437604. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Where is Gaetano Capone located?

Gaetano Capone practices at 3998 Red Lion Rd Suite 306, Philadelphia, PA 19114. The listed phone number is (215) 281-0800.

What is Gaetano Capone's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Gaetano Capone enrolled in Medicare?

Yes. Gaetano Capone 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 organization bills Medicare for Gaetano Capone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gaetano Capone reassigns Medicare benefits to Greater Philadelphia Cardiology Assc Inc (Philadelphia, PA). The 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 Gaetano Capone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gaetano Capone accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Gaetano Capone 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 Gaetano Capone affiliated with any hospitals?

According to CMS data, Gaetano Capone is affiliated with Jefferson Health- Northeast.

When was this NPI record last updated?

The NPPES record for Gaetano Capone was last updated on February 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.