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DR. JEFFREY W MUMIE D.O.
NPI 1689607038
Family Medicine in Elverson, PA

Active since July 09, 2006PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
315 DARBY SQ, ELVERSON, PA 19520(610) 898-5240(610) 286-6760 Get Directions Write a Review

NPPES record last updated: March 10, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jeffrey W Mumie D.o. NPPES

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

DR. JEFFREY W MUMIE D.O. (NPI 1689607038) is an individual family medicine provider in Elverson, Pennsylvania, licensed in Pennsylvania (OS012636) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Philadelphia College Of Osteopathic Medicine (2002).

NPPES Registry Identity

NPI1689607038
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JEFFREY W MUMIECredential: D.O.
Location Address315 DARBY SQElverson, PA 19520-9302
Mailing AddressPo Box 13579Reading, PA 19612-3579
Phone(610) 898-5240
Fax(610) 286-6760
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2002
Enumeration DateJuly 9, 2006
Last NPPES UpdateMarch 10, 2017
✔ NPI 1689607038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in PA · OS012636
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
315 DARBY SQ, Elverson, PA 19520
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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

Dr. Jeffrey W Mumie D.o. 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 ID3971527755
PECOS Enrollment IDI20060119000442
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 11

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.
414 services213 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.
173 services119 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
154 services154 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
48 services47 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.
26 services22 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
22 services21 patients

Hospital Affiliations CMS Care Compare 5

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Penn State Health St. Joseph

Acute Care Hospitals · Reading, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390096
Location2500 Bernville RoadReading, PA 19605 · Berks County
Emergency services Birthing friendly

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390123
Location1600 East High StreetPottstown, PA 19464 · Montgomery County
Emergency services

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number390127
Location140 Nutt RoadPhoenixville, PA 19460 · Chester County
Emergency services Birthing friendly

Wellspan Ephrata Community Hospital

Acute Care Hospitals · Ephrata, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390225
Location169 Martin AvenueEphrata, PA 17522 · Lancaster County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19520 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
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.

81.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.56
Promoting Interoperability97
Improvement Activities40
Cost65.23

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
12%240 patients1/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
21%34 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers27 claims74 services$5.86 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
3 suppliers21 claims21 services$0.97 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 2

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

DR. LISA ANN GALLAGHER DO
Family Medicine
315 DARBY SQ
ELVERSON, PA 19520
Chester County (610) 898-5240
SIERRA D HYATT CRNP
Nurse Practitioner (Family)
315 DARBY SQ
ELVERSON, PA 19520
Chester County (610) 898-5240

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 Jeffrey Mumie's NPI number?

The NPI number for Jeffrey Mumie is 1689607038. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Jeffrey Mumie located?

Jeffrey Mumie practices at 315 Darby Sq, Elverson, PA 19520. The listed phone number is (610) 898-5240.

What is Jeffrey Mumie's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jeffrey Mumie enrolled in Medicare?

Yes. Jeffrey Mumie 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.

What insurance does Jeffrey Mumie accept?

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

According to CMS data, Jeffrey Mumie is affiliated with Reading Hospital, Penn State Health St. Joseph, Pottstown Hospital, Phoenixville Hospital and Wellspan Ephrata Community Hospital.

When was this NPI record last updated?

The NPPES record for Jeffrey Mumie was last updated on March 10, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.