Individual provider Active NPI

Katherine Hallock

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1073977146
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD471467 Issued in PA
Practice address
1516 Locust St
Philadelphia, PA 19102-4409
Phone
(215) 545-5459
NPI assigned
Apr 5, 2016
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD471467 PA Primary

Addresses

Primary practice location

1516 Locust St
Philadelphia, PA 19102-4409

Mailing address

1516 Locust St
Philadelphia, PA 19102-4409
Phone (215) 545-5459

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200831001876 PA Practitioner - Dermatology 2264859644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Pennsylvania State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ringpfeil Advanced Dermatology PCGroup PAC ID 8022015486, 13 clinicians

Practice addresses (Care Compare)

569 W Lancaster Ave
Haverford, PA 19041-1416
Phone (610) 525-5250

Merit-based Incentive Payment System (MIPS)

Final score
97.25 of 100Reported as group
Quality
95
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions191
Removal or shaving of skin growth1-10
Skin biopsy78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD471467PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ringpfeil Advanced Dermatology PC Dermatology CurrentSince Sep 25, 2023 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 1, 2020 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Dermatology CurrentSince Aug 1, 2020 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

121 N Nyes Rd
Ste C
Harrisburg, PA 17112
Phone (717) 657-4045

569 W Lancaster Ave
Haverford, PA 19041
Phone (610) 525-5250

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A4
Hershey, PA 17033
Phone (717) 531-6261

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

1516 Locust St
Philadelphia, PA 19102
Phone (215) 545-5459

339 E Lancaster Ave
Wynnewood, PA 19096
Phone (610) 649-1391

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDCAA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1073977146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024409",
            "telephone_number": "215-545-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 LOCUST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024409",
            "telephone_number": "215-545-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD471467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.