DR. MICHAEL L SINITSA M.D.
NPI 1922009307
Family Medicine in Reading, PA

Active since August 09, 2005PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
4885 DEMOSS RD, SUITE 201, READING, PA 19606(610) 779-9489(610) 779-9487 Get Directions Write a Review

NPPES record last updated: September 13, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael L Sinitsa M.d. NPPES

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

DR. MICHAEL L SINITSA M.D. (NPI 1922009307) is an individual family medicine provider in Reading, Pennsylvania, licensed in Pennsylvania (MD067981L) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1922009307
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MICHAEL L SINITSACredential: M.D.
Location Address4885 DEMOSS RD, SUITE 201Reading, PA 19606-9023
Mailing Address4885 Demoss Rd, Suite 201Reading, PA 19606-9023 · (610) 779-9489 · Fax (610) 779-9487
Fax(610) 779-9487
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateAugust 9, 2005
Last NPPES UpdateSeptember 13, 2016
NPI 1922009307 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 · MD067981L
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.
4885 DEMOSS RD, Reading, PA 19606

Other Identifiers 3

Medicare UPING94435PA
Medicaid001818504PA
Medicare PIN028266PA

Accepted 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. Michael L Sinitsa M.d. 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 ID5496654899
PECOS Enrollment IDI20050126000041
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 10

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.
785 services338 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.
269 services269 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.
88 services84 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.
69 services56 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.
37 services29 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
22 services19 patients

Hospital Affiliations CMS Care Compare 4

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

Wellspan Good Samaritan Hospital

Acute Care Hospitals · Lebanon, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390066
Location252 South 4th StreetLebanon, PA 17042 · Lebanon 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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19606 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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…
11%274 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
31%52 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

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
13 suppliers59 claims159 services$5.67 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 18

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

Internal Medicine
4885 DEMOSS RD, SUITE 200
READING, PA 19606
Internal Medicine
4885 DEMOSS RD, SUITE 200
READING, PA 19606
Nurse Practitioner (Gerontology)
4885 DEMOSS RD, SUITE 200
READING, PA 19606
Family Medicine
4885 DEMOSS RD, STE 203
READING, PA 19606
Durable Medical Equipment & Medical Supplies
4885 DEMOSS RD, SUITE 102
READING, PA 19606
Physician Assistant (Medical)
4885 DEMOSS RD, SUITE 201
READING, PA 19606
Clinic/Center (Primary Care)
4885 DEMOSS RD, SUITE 203
READING, PA 19606
Podiatrist
4885 DEMOSS RD, SUITE 103
READING, PA 19606

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 Michael Sinitsa's NPI number?

The NPI number for Michael Sinitsa is 1922009307. It was assigned to this individual provider in the NPPES registry on August 9, 2005.

Where is Michael Sinitsa located?

Michael Sinitsa practices at 4885 Demoss Rd Suite 201, Reading, PA 19606. The listed phone number is (610) 779-9489.

What is Michael Sinitsa's specialty?

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

Is Michael Sinitsa enrolled in Medicare?

Yes. Michael Sinitsa 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 Michael Sinitsa accept?

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

According to CMS data, Michael Sinitsa is affiliated with Reading Hospital, Wellspan Good Samaritan Hospital, Penn State Health St. Joseph and Pottstown Hospital.

When was this NPI record last updated?

The NPPES record for Michael Sinitsa was last updated on September 13, 2016. 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.