DR. RICHARD PAUL DENICOLA M.D.
NPI 1932595469
Internal Medicine - Gastroenterology in Philadelphia, PA

Q: What is Richard Denicola's NPI number?

The NPI number for Richard Denicola is 1932595469. It was assigned to this individual provider in the NPPES registry on April 10, 2015.

Q: What is Richard Denicola'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 Richard Denicola was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 10, 2015PECOS EnrolledAccepts Medicare Assignment

1101 CHESTNUT ST, PHILADELPHIA, PA 19107(215) 955-8900(215) 955-5245 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 15, 2021, Apr 26, 2021 (2 updates tracked since 2021).

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About Dr. Richard Paul Denicola M.d. NPPES

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

DR. RICHARD PAUL DENICOLA M.D. (NPI 1932595469) is an individual gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD473455) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Thomas Jefferson University Hospital, and is a graduate of Rutgers New Jersey Medical School (2015).

NPPES Registry Identity

NPI1932595469

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. RICHARD PAUL DENICOLACredential: M.D.

Location Address1101 CHESTNUT STPhiladelphia, PA 19107-3612

Mailing Address132 South 10th Street, 480 Main BuildingPhiladelphia, PA 19107-5244 · (215) 955-8900 · Fax (215) 955-5245

Phone(215) 955-8900

Fax(215) 955-5245

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 2015

Enumeration DateApril 10, 2015

Last NPPES UpdateOctober 28, 20242 updates tracked since enumeration

NPPES CertifiedOctober 28, 2024

✔ NPI 1932595469 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 · MD473455

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 MD473455 (PA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1101 CHESTNUT ST, Philadelphia, PA 19107

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Richard Paul Denicola 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 ID6204156375

PECOS Enrollment IDI20210527002184

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 Richard Denicola reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jefferson University Physicians

0.2 mi

General Practice

33 S. 9TH STREET
Philadelphia, PA 19107

Reassigned Medicare billing, Pennsylvania enrollment
1,739 clinicians in this Medicare group

NPI 1326093675 (215) 955-0000

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 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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

47 services47 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.

47 services42 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

40 services40 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.

36 services36 patients

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

35 services32 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.

31 services31 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

29 services29 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.

27 services21 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

24 services24 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

19 services12 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.

13 services12 patients

Hospital Affiliations CMS Care Compare

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

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390174

Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19107 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.

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.

EMILY RUBIN R.D.

Dietitian, Registered

1101 CHESTNUT ST
PHILA, PA 19107

Philadelphia County (215) 955-8900

LAUREL VIRGINIA KOVALCHICK MD

Psychiatry & Neurology (Neurology)

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (215) 955-1234

CHRISTOPHER JAMES ADKINS M.D.

Internal Medicine (Gastroenterology)

1101 CHESTNUT ST
PHILA, PA 19107

Philadelphia County (215) 955-8900

SARAH F ADAMS CCC-SLP

Speech-Language Pathologist

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (215) 955-6760

REBECCA LOH

Internal Medicine (Gastroenterology)

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (215) 955-8900

EDDIE DIAZ SERRANO AUD

Audiologist

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (215) 955-6760

RORY MARGARET ANDERSON CRNP

Nurse Practitioner (Family)

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (800) 533-3669

MAEVE CALLAHAN CRNP

Nurse Practitioner (Adult Health)

1101 CHESTNUT ST
PHILADELPHIA, PA 19107

Philadelphia County (800) 533-3669

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 Richard Denicola's NPI number?

The NPI number for Richard Denicola is 1932595469. It was assigned to this individual provider in the NPPES registry on April 10, 2015.

Where is Richard Denicola located?

Richard Denicola practices at 1101 Chestnut St, Philadelphia, PA 19107. The listed phone number is (215) 955-8900.

What is Richard Denicola's specialty?

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

Is Richard Denicola enrolled in Medicare?

Yes. Richard Denicola 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 Richard Denicola's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Denicola reassigns Medicare benefits to Jefferson University Physicians (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 Richard Denicola's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Richard Denicola accept?

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

According to CMS data, Richard Denicola is affiliated with Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Richard Denicola was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.