NPIMap

Individual provider Active NPI

Stephen John Kovach III, MD

  • Plastic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1255463683
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD432250 Issued in PA
Practice address
3400 Civic Center Blvd
1St Floor East Pavillion
Philadelphia, PA 19104-5161
Phone
(215) 662-7300
Fax
(215) 349-5895
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD432250 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
1St Floor East Pavillion
Philadelphia, PA 19104-5161

Mailing address

3400 Civic Center Blvd
1St Floor East Pavillion
Philadelphia, PA 19104-5161
Phone (215) 662-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071029000516 PA Practitioner - Plastic and Reconstructive Surgery 1052408622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
George Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2096

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
88.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision73
Removal of tissue44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Surgery CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

23 Morris Ave
#219
Bryn Mawr, PA 19010
Phone (484) 883-6827

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

3737 Market St
Ste 701
Philadelphia, PA 19104

230 W Washington Sq
Ste 101
Philadelphia, PA 19106
Phone (215) 829-6320

3737 Market St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-8664

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Civic Center Blvd
Fl 1E
Philadelphia, PA 19104
Phone (215) 615-5252

3400 Spruce St
#10
Philadelphia, PA 19104
Phone (215) 662-2096

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

800 Walnut St
Fl 20
William Penn Annex West, PA 19107
Phone (215) 829-2092

100 E Lancaster Ave
#275
Wynnewood, PA 19096
Phone (215) 622-3743

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1255463683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "1ST FLOOR EAST PAVILLION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045161",
            "telephone_number": "215-662-7300",
            "fax_number": "215-349-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "1ST FLOOR EAST PAVILLION",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045161",
            "telephone_number": "215-662-7300",
            "fax_number": "215-349-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "STEPHEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD432250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.