DR. PATRICIA ANN MARGETAS D.O.
NPI 1346475340
Internal Medicine in York, PA

NPI Status: Active since May 19, 2009

Contact Information

4020 CARLISLE RD
YORK, PA
ZIP 17315
Phone: (717) 851-6400
Fax: (717) 851-6410

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  • Individual
  • Female
  • Years of Experience 17
  • Internal Medicine
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PATRICIA MARGETAS

This page provides the complete NPI Profile along with additional information for Patricia Margetas, an internist established in York, Pennsylvania with a medical specialization in Internal Medicine and more than 17 years of experience. She graduated from Philadelphia College Of Osteopathic Medicine in 2009. The healthcare provider is registered in the NPI registry with number 1346475340 assigned on May 2009. The practitioner's primary taxonomy code is 207R00000X with license number OS016139 (PA). The provider is registered as an individual and her NPI record was last updated 9 years ago.

NPI
1346475340
Provider Name
DR. PATRICIA ANN MARGETAS D.O.
Other Name
PATRICIA ANN BURGER
Other Name Type
Former Name (1)
Gender
Female
Entity Type
Individual
Location Address
4020 CARLISLE RD YORK, PA 17315
Location Phone
(717) 851-6400
Location Fax
(717) 851-6410
Mailing Address
3421 CONCORD RD YORK, PA 17402
Mailing Phone
(717) 851-6400
Mailing Fax
(717) 851-6410
Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year
2009
Is Sole Proprietor?
No
Enumeration Date
05-19-2009
Last Update Date
07-21-2016
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An internist like Patricia Margetas 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

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
OS016139
License State
PA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
30141866OTHER (01)PAAMERIHEALTH MERCY
2792924OTHER (01)PAHIGHMARK BLUE SHIELD
30147722OTHER (01)PAAMERIHEALTH CARITAS-EYFM
P009460OTHER (01)PAGATEWAY
30147721OTHER (01)PAAMERIHEALTH CARITAS-DIM
419611OTHER (01)PAUPMC
102780683MEDICAID (05)PA 
268003FLTMEDICARE PIN (08)PA 

Medicare Participation & PECOS Enrollment Status

Patricia Margetas 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.

Patricia Margetas 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: 6507011228

    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: I20130304000334

    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.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    7 DME suppliers used 25 Medicare Claims 72 Services Paid

  • DME-Medical/Surgical Supplies (DA000N)

    Lancets, per box of 100 (HCPCS:A4259)

    6 DME suppliers used 17 Medicare Claims 19 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.

Administration of influenza virus vaccine

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.

This service was performed 18 times for 18 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

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.

This service was performed 14 times for 14 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 71 times for 55 patients

Influenza vaccine split virus, preservative free

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

This service was performed 16 times for 16 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $31.58 for a new patient copayment and $24.2 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 17315 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $126.34
  • Minimum New Patient Price $54.64
  • Maximum New Patient Price $166.87
  • Average New Patient Copayment $31.58
  • Minimum New Patient Copayment $13.66
  • Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.82
  • Minimum Established Patient Price $17.33
  • Maximum Established Patient Price $135.84
  • Average Established Patient Copayment $24.2
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $33.96

* 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. Patricia Margetas is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WELLSPAN YORK HOSPITAL1001 SOUTH GEORGE STREET
YORK, PA 17403
(717) 851-4495Acute Care Hospitals

Reviews for DR. PATRICIA ANN MARGETAS D.O.

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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.
1346475340
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2386871038
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 8 + 6 + 8 + 7 + 1 + 0 + 3 + 8 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1346475340 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013344522MRS. DONNA MARIE VESNAVER BS,RPSGT,RST,RRT-SDS
Individual
Technician, Other4020 CARLISLE RD
DOVER, PA 17315
(717) 812-2191
1558464644MR. CHRISTOPHER FRANKLIN DUE MD
Individual
Internal Medicine4020 CARLISLE RD
DOVER, PA 17315
(717) 851-6400
1619044880WELLSPAN MEDICAL GROUP
Organization
Internal Medicine4020 CARLISLE RD
DOVER, PA 17315
(717) 851-6400
1770515405DR. JOHN RIZZARI GANDIONCO MD
Individual
Internal Medicine4020 CARLISLE RD
DOVER, PA 17315
(717) 851-6400
1104855758DR. RAJESH KUMAR NALLAPATI MD
Individual
Internal Medicine4020 CARLISLE RD
DOVER, PA 17315
(717) 851-6400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346475340, enumerated in the NPI registry as an "individual" on May 19, 2009

The provider is located at 4020 Carlisle Rd York, Pa 17315 and the phone number is (717) 851-6400

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 17 years of experience. She graduated from Philadelphia College Of Osteopathic Medicine in 2009.

The provider might be accepting Accepts: AmeriHealth, Medicare, Medicaid, Blue Cross Blue. 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 $126.34 with an average copayment of $31.58 for new patient appointments. Established patients should expect a typical charge of $96.82 and an average copayment of 24.2. 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: Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Established patient office or other outpatient visit, 20-29 minutes and Influenza vaccine split virus, preservative free.

The practitioner is affiliated to the following hospital(s): WELLSPAN YORK HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on May 19, 2009. 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.