NPIMap

Individual provider Active NPI

Brett Lipetz, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1396202875
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS021192 Issued in PA
Practice address
4190 City Ave
Philadelphia, PA 19131-1626
Phone
(215) 871-6694
NPI assigned
Feb 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS021192 PA Primary

Addresses

Primary practice location

4190 City Ave
Philadelphia, PA 19131-1626

Mailing address

4190 City Ave
Philadelphia, PA 19131-1626

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
I20221014000308 PA Practitioner - Internal Medicine 9537499041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS021192PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Hill Clinic Company, LLC Internal Medicine CurrentSince Jul 18, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Oct 4, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC CurrentSince Jul 18, 2022 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Oct 4, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
CHH Community Health Past Accepting new patients

Locations

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

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 9

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": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1396202875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 CITY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311626",
            "telephone_number": "215-871-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPETZ",
        "first_name": "BRETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-21",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS021192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.