KENNETH ROTHSTEIN MD
NPI 1790753317
Internal Medicine - Gastroenterology in Philadelphia, PA

Q: What is Kenneth Rothstein's NPI number?

The NPI number for Kenneth Rothstein is 1790753317. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Q: What is Kenneth Rothstein's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Rothstein was last updated on October 4, 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 March 09, 2006PECOS EnrolledAccepts Medicare Assignment

85.48/100

CMS Quality Rating

3400 CIVIC CENTER BLVD FL 4, PHILADELPHIA, PA 19104(215) 349-8222 Get Directions Write a Review

NPPES record last updated: October 4, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 4, 2019, Jan 12, 2018 (2 updates tracked since 2018).

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About Kenneth Rothstein Md NPPES

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

KENNETH ROTHSTEIN MD (NPI 1790753317) is an individual gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD044179E) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with University Medical Center Of Princeton At Plainsboro, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1790753317

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameKENNETH ROTHSTEINCredential: MD

Location Address3400 CIVIC CENTER BLVD FL 4Philadelphia, PA 19104

Mailing Address3400 Civic Center Blvd Fl 4Philadelphia, PA 19104-5127 · (215) 349-8222

Phone(215) 349-8222

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 1986

Enumeration DateMarch 9, 2006

Last NPPES UpdateOctober 4, 20192 updates tracked since enumeration

✔ NPI 1790753317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in PA · MD044179E

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD044179E (PA)

Also ListedInternal Medicine · Transplant HepatologyTaxonomy 207RT0003X · License MD044179E (PA)

3400 CIVIC CENTER BLVD FL 4, Philadelphia, PA 19104

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Secondary Practice Location 1

Location 13400 Spruce St, 2 DullesPhiladelphia, PA 19104 · Phone (215) 349-8222

Other Identifiers 1

Medicaid001237178PA

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

Kenneth Rothstein 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 ID4789777905

PECOS Enrollment IDI20070905000072, I20080508000487

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.

125 services102 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.

81 services71 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

45 services22 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.

43 services38 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

35 services30 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.

29 services29 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

28 services28 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

25 services24 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

21 services21 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

11 services11 patients

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

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

University Medical Center Of Princeton At Plainsboro

Acute Care Hospitals · Plainsboro, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310010

LocationOne-Five Plainsboro RoadPlainsboro, NJ 08536 · Middlesex County

Emergency services Birthing friendly

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

Chester County Hospital

Acute Care Hospitals · West Chester, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390179

Location701 East Marshall StreetWest Chester, PA 19380 · Chester County

Emergency services Birthing friendly

Doylestown Hospital

Acute Care Hospitals · Doylestown, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390203

Location595 West State StDoylestown, PA 18901 · Bucks County

Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390223

Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County

Emergency services

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 5

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

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

5 suppliers63 claims2,355 services$0.28 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers25 claims2,310 services$0.14 avg. paid by Medicare

Sirolimus, oral, 1 mg J7520

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier12 claims360 services$2.80 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

5 suppliers49 claims49 services$17.00 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

4 suppliers50 claims51 services$11.17 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.

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