Individual provider Active NPI

Ronald P Dematteo, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1376525964
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD049705L Issued in PA
Practice address
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone
(215) 662-2626
Fax
(215) 614-0244
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD049705L PA Primary
Surgery Physician 208600000X 207176 NY

Addresses

Primary practice location

3400 Civic Center Blvd
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone (215) 662-2626

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
I20171101002818 PA Practitioner - General Surgery 2961527411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
JS Weill Medical College, Cornell University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd 4TH Floor Per
Gi Surgery Pcam
Philadelphia, PA 19104-5127
Phone (215) 662-2626

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD049705LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Surgery CurrentSince Sep 6, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 6, 2017 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300

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

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

145 King of Prussia Rd
Ste 203
St Davids, PA 19087
Phone (215) 662-8664

Organizations & group practices 5

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 3

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1376525964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2626",
            "fax_number": "215-614-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-662-2626",
            "fax_number": "215-614-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTEO",
        "first_name": "RONALD",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD049705L",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "207176",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.