Active NPI
Kenneth Fred Woerthwein, MD
- Family Medicine Physician
- York, PA
National Provider Identifier
1063430189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD012836E
- Practice address
- 1575 Bannister St
Suite 1
York, PA 17404-4946 - Phone
- (717) 812-2000
- Fax
- (717) 812-2010
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD012836E | PA | Primary |
Addresses
Primary practice location
1575 Bannister St
Suite 1
York, PA 17404-4946
Mailing address
1803 Mount Rose Ave
Suite B3
York, PA 17403-3026
Phone (717) 851-1405
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P002819 | Other | PA | GATEWAY-WMG |
| 234118 | Other | PA | MAMSI-WMG |
| 30042 | Other | PA | JOHNS HOPKINS |
| 4265297 | Other | PA | AETNA |
| 1142412 | Other | PA | AMERIHEALTH MERCY-WMG |
| 81048 | Other | PA | UNISON-WMG |
| 542980 | Other | MD | CAREFIRST MD BCBS |
| 43185 | Other | PA | GEISINGER |
| 01450202 | Other | PA | CAPITAL BLUE CROSS-WMG |
| 000664038 | Medicaid | PA | |
| 046628 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160613001263 | PA | Order and Referring Only - Family Practice | 0244261162 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264723200000",
"number": "1063430189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 MOUNT ROSE AVE",
"address_2": "SUITE B3",
"city": "YORK",
"state": "PA",
"postal_code": "174033026",
"telephone_number": "717-851-1405",
"fax_number": "717-851-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 BANNISTER ST",
"address_2": "SUITE 1",
"city": "YORK",
"state": "PA",
"postal_code": "174044946",
"telephone_number": "717-812-2000",
"fax_number": "717-812-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOERTHWEIN",
"first_name": "KENNETH",
"middle_name": "FRED",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2010-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD012836E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY-WMG",
"identifier": "P002819",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI-WMG",
"identifier": "234118",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHNS HOPKINS",
"identifier": "30042",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4265297",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY-WMG",
"identifier": "1142412",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON-WMG",
"identifier": "81048",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "542980",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "43185",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS-WMG",
"identifier": "01450202",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000664038",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "046628",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.