MICHAEL J STEPHEN MD
NPI 1245393743
Internal Medicine - Pulmonary Disease in Philadelphia, PA
NPI Status: Active since December 18, 2006
Contact Information
219 N BROAD ST
9TH FLOOR
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 762-2688
- Individual
- Male
- Years of Experience 25
- Internal Medicine
- Pulmonary Disease
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL STEPHEN
This page provides the complete NPI Profile along with additional information for Michael Stephen, an internist established in Philadelphia, Pennsylvania with a medical specialization in Internal Medicine, focusing in pulmonary disease and more than 25 years of experience. He graduated from Boston University School Of Medicine in 2001. The healthcare provider is registered in the NPI registry with number 1245393743 assigned on December 2006. The practitioner's primary taxonomy code is 207RP1001X with license number MD432837 (PA). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1245393743
- Provider Name
- MICHAEL J STEPHEN MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 219 N BROAD ST 9TH FLOOR PHILADELPHIA, PA 19107
- Location Phone
- (215) 762-2688
- Mailing Address
- 245 N 15TH ST 12TH FLOOR PHILADELPHIA, PA 19102
- Medical School Name
- BOSTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2001
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-18-2006
- Last Update Date
- 08-31-2016
- Code Navigator
An internist like Michael Stephen is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Pulmonary Disease
- Taxonomy Code
- 207RP1001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD432837
- License State
- PA
- Taxonomy Description
- An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael Stephen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Stephen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1850455809
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090205000509, I20220809004138
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Unknown
Other-Enteral and Parenteral (OB006N)
In-line cartridge containing digestive enzyme(s) for enteral feeding, each (HCPCS:B4105)
1 DME suppliers used 11 Medicare Claims 330 Services Paid
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
6 DME suppliers used 46 Medicare Claims 46 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
2 DME suppliers used 16 Medicare Claims 16 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
15 DME suppliers used 59 Medicare Claims 59 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG006N)
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)
8 DME suppliers used 18 Medicare Claims 3745 Services Paid
DME-Drugs Administered Through DME (DG006N)
Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg (HCPCS:J7614)
2 DME suppliers used 12 Medicare Claims 2685 Services Paid
DME-Drugs Administered Through DME (DG000N)
Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7639)
7 DME suppliers used 43 Medicare Claims 3828 Services Paid
DME-Drugs Administered Through DME (DG000N)
Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams (HCPCS:J7682)
6 DME suppliers used 30 Medicare Claims 1472 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 30-39 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
New patient office or other outpatient visit, 45-59 minutes
New patient office or other outpatient visit, 60-74 minutes
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.
This service was performed 22 times for 21 patientsFollow-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.
This service was performed 26 times for 16 patientsThis 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.
This service was performed 34 times for 34 patientsThis 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.
This service was performed 29 times for 29 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.29 for a new patient copayment and $26.3 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 19107 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $137.17
- Minimum New Patient Price $59.88
- Maximum New Patient Price $180.99
- Average New Patient Copayment $34.29
- Minimum New Patient Copayment $14.97
- Maximum New Patient Copayment $45.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.21
- Minimum Established Patient Price $19.3
- Maximum Established Patient Price $147.29
- Average Established Patient Copayment $26.3
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $36.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Stephen is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
HOSPITAL OF UNIV OF PENNSYLVANIA | 34TH & SPRUCE STS PHILADELPHIA, PA 19104 | (215) 662-3227 | Acute Care Hospitals | |
PENN PRESBYTERIAN MEDICAL CENTER | 51 NORTH 39TH STREET PHILADELPHIA, PA 19104 | (215) 662-8000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 2 | 4 | 5 | 3 | 9 | 3 | 7 | 4 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 8 | 5 | 6 | 9 | 6 | 7 | 8 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 8 + 5 + 6 + 9 + 6 + 7 + 8 + 24 = 77 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
80 - 77 = 3 | 3 |
The NPI number 1245393743 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1497713556 | WEI T HSU M.D. Individual | Dermatology | 219 N BROAD ST 4TH FL PHILADELPHIA, PA 19107 (215) 762-5550 |
1396703716 | PETER B KURNIK MD Individual | Internal Medicine (Cardiovascular Disease) | 219 N BROAD ST 6TH FLOOR PHILADELPHIA, PA 19107 (215) 762-5080 |
1124077383 | DENNIS H NOVACK MD Individual | Internal Medicine | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5037 |
1639128655 | DR. LENORE ASBEL M.D. Individual | Internal Medicine (Infectious Disease) | 219 N BROAD ST 5TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6555 |
1689623613 | WILLIAM G BERLINGER MD Individual | Internal Medicine | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5037 |
1073563367 | DIANA M MORGENSTERN MD Individual | Internal Medicine | 219 N BROAD ST 6TH FLOOR PHILA, PA 19107 (215) 762-5181 |
1578513271 | JYOTI PILLAI MD Individual | Psychiatry & Neurology (Neurology) | 219 N BROAD ST 7TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6915 |
1104879048 | GEORGE J AMROM MD Individual | Surgery | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5010 |
1437103116 | RAYMOND C TALUCCI MD Individual | Surgery | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5010 |
1619924321 | DR. THOMPSON H BOYD M D Individual | Internal Medicine | 219 N BROAD ST 8TH FLOOR PHILADELPHIA, PA 19107 (215) 762-5037 |
1417904129 | ANA E NUNEZ MD Individual | Internal Medicine | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5037 |
1669419545 | YELENA DOYCH MD Individual | Ophthalmology | 219 N BROAD ST 3RD FL PHILADELPHIA, PA 19107 (215) 762-3937 |
1932147816 | MICHAEL S WEINGARTEN MD Individual | Surgery (Vascular Surgery) | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-5010 |
1174561542 | KARTHIK M RANGANNA MD Individual | Internal Medicine (Nephrology) | 219 N BROAD ST 5TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6144 |
1801835129 | MYSORE ANIL KUMAR MD Individual | Transplant Surgery | 219 N BROAD ST 8TH FL PHILADELPHIA, PA 19107 (215) 762-3900 |
1265471403 | MICHAEL HEIFETS MD Individual | Internal Medicine (Nephrology) | 219 N BROAD ST 5TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6144 |
1811938558 | HERBERT PATRICK MD Individual | Internal Medicine (Pulmonary Disease) | 219 N BROAD ST 9TH FL PHILADELPHIA, PA 19107 (215) 762-2688 |
1841232832 | SANDRA P LEVISON MD Individual | Internal Medicine (Nephrology) | 219 N BROAD ST 5TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6144 |
1487696639 | KWAN E KIM MD Individual | Internal Medicine (Nephrology) | 219 N BROAD ST 5TH FLOOR PHILADELPHIA, PA 19107 (215) 762-6144 |
1932141843 | MYRON YANOFF MD Individual | Ophthalmology | 219 N BROAD ST 3RD FL PHILADELPHIA, PA 19107 (215) 762-3937 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245393743, enumerated in the NPI registry as an "individual" on December 18, 2006
The provider is located at 219 N Broad St 9th Floor Philadelphia, Pa 19107 and the phone number is (215) 762-2688
The provider's speciality is Internal Medicine with taxonomy code 207RP1001X with a focus in Pulmonary Disease
The provider has more than 25 years of experience. He graduated from Boston University School Of Medicine in 2001.
The provider might be accepting Accepts: Molina Healthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $137.17 with an average copayment of $34.29 for new patient appointments. Established patients should expect a typical charge of $105.21 and an average copayment of 26.3. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 30-39 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, New patient office or other outpatient visit, 45-59 minutes and New patient office or other outpatient visit, 60-74 minutes.
The practitioner is affiliated to the following hospital(s): HOSPITAL OF UNIV OF PENNSYLVANIA and PENN PRESBYTERIAN MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on December 18, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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