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

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  • 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
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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.

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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

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 patients

Follow-up hospital inpatient care per day, typically 35 minutes

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.

This service was performed 26 times for 16 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 34 times for 34 patients

New patient office or other outpatient visit, 60-74 minutes

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.

This service was performed 29 times for 29 patients

Physician 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 PENNSYLVANIA34TH & SPRUCE STS
PHILADELPHIA, PA 19104
(215) 662-3227Acute Care Hospitals
PENN PRESBYTERIAN MEDICAL CENTER51 NORTH 39TH STREET
PHILADELPHIA, PA 19104
(215) 662-8000Acute 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.
1245393743
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
228569678
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 = 33

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
Dermatology219 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 Medicine219 N BROAD ST 8TH FL
PHILADELPHIA, PA 19107
(215) 762-5037
1639128655DR. 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 Medicine219 N BROAD ST 8TH FL
PHILADELPHIA, PA 19107
(215) 762-5037
1073563367 DIANA M MORGENSTERN MD
Individual
Internal Medicine219 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
Surgery219 N BROAD ST 8TH FL
PHILADELPHIA, PA 19107
(215) 762-5010
1437103116 RAYMOND C TALUCCI MD
Individual
Surgery219 N BROAD ST 8TH FL
PHILADELPHIA, PA 19107
(215) 762-5010
1619924321DR. THOMPSON H BOYD M D
Individual
Internal Medicine219 N BROAD ST 8TH FLOOR
PHILADELPHIA, PA 19107
(215) 762-5037
1417904129 ANA E NUNEZ MD
Individual
Internal Medicine219 N BROAD ST 8TH FL
PHILADELPHIA, PA 19107
(215) 762-5037
1669419545 YELENA DOYCH MD
Individual
Ophthalmology219 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 Surgery219 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
Ophthalmology219 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.