Peter D Ennis, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

MD059272L Issued in PA

Practice address

30 Lawrence Rd
Suite 201
Broomall, PA 19008-3301

Phone

(610) 492-5900

Fax

(610) 492-5903

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Hematology/Oncology

Education

Drexel University College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Consultants in Medical Oncology and Hematology PCGroup PAC ID 2365413127, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Merit-based Incentive Payment System (MIPS)

Final score

97.82 of 100Reported as individual

Quality

85.63

Improvement activities

40

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.

• Consultants in Medical Oncology & Hematology, PC

  • Hematology & Oncology Physician
  • Broomall, PA
  • NPI 1043265820
  Medicare reassignment Care Compare group NPD
• Integrated Palliative Care, PC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Broomall, PA
  • NPI 1346815024
  NPD

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

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1508893926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LAWRENCE RD",
            "address_2": "SUITE 201",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083301",
            "telephone_number": "610-492-5900",
            "fax_number": "610-492-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LAWRENCE RD",
            "address_2": "SUITE 201",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083301",
            "telephone_number": "610-492-5900",
            "fax_number": "610-492-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD059272L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2512918",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA TRADITIONAL",
            "identifier": "7910189",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0651758000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "779455",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hematology & Oncology Physician in Broomall, PA
• Providers in Broomall, PA by specialty
• Hematology & Oncology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.