Roman Bronfenbrener, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD457011 Issued in PA

Practice address

1122 Street Rd Ste 204
Southampton, PA 18966-4218

Phone

(215) 999-7546

Fax

(215) 608-6008

NPI assigned

May 4, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists of PennsylvaniaGroup PAC ID 4284051079, 5 clinicians

University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

84.91 of 100Reported as group

Quality

73.58

Promoting interoperability

100

Improvement activities

40

Cost

76.13

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dermatology Specialists of Pennsylvania

  • Dermatology Physician
  • Southampton, PA
  • NPI 1790395747
  Medicare reassignment Care Compare group NPD Authorized official
• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment Care Compare group NPD
• Dermatology LTD

  • Dermatology Physician
  • Media, PA
  • NPI 1477508257
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1225426349
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• University of Penn - Medical Group

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1093725145
  NPD (past)
• Zitelli & Brodland PC

  • MOHS-Micrographic Surgery Physician
  • Pittsburgh, PA
  • NPI 1184790099
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Trustees of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1134488638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 STREET RD STE 204",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664218",
            "telephone_number": "215-999-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 STREET RD STE 204",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664218",
            "telephone_number": "215-999-7546",
            "fax_number": "215-608-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONFENBRENER",
        "first_name": "ROMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2024-04-05",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "MD457011",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD457011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albina Bril, PHARMD
• Stephen Britchkow
• Melissa Brizzell, MFT, MA
• Elena Brodsky, RD, LDN
• Leonard A Brody, MD
• Toni Bronfenbrener, CRNP
• Mitchell Dean Brotsky, DPT
• Bucks County Surgical Services, LLC
• Bucks Mont Psychotherapy LLC
• Alan Bui, DDS

• Dermatology Physician in Southampton, PA
• Providers in Southampton, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.