NPIMap

Individual provider Active NPI

Afton Renette Metkowski, MD

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1558723536
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD470395 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-3376
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD470395 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3401 N. Broad Street
Boyer Pavilion BLDG., 2ND Floor, Suite 226a
Philadelphia, PA 19140
Phone (267) 896-3361

Other practice location 1

757 Westwood Plz
B711 Rrumc
Los Angeles, CA 90095-7419
Phone (310) 267-9129

Other practice location 2

1316 W. Ontario St
Jones Hall, 1st Floor
Philadelphia, PA 19140
Phone (800) 836-7536

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
I20231016003215 PA Practitioner - Dermatology 2961826011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Temple University School of Medicine, 2016
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

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions87
Removal or shaving of skin growth1-10
Skin biopsy101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD470395PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Sep 12, 2023 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Sep 12, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Dermatology Past Accepting new patients

Locations

515 Pennsylvania Ave
Ft Washington, PA 19034
Phone (215) 641-0700

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

3401 N Broad St
Bldg 2ND
Philadelphia, PA 19140

1316 W Ontario St
Fl 1
Philadelphia, PA 19140
Phone (215) 707-7901

Organizations & group practices 4

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 8

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1558723536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD STREET",
            "address_2": "BOYER PAVILION BLDG., 2ND FLOOR, SUITE 226A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "267-896-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_2": "B711 RRUMC",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900957419",
            "country_code": "US",
            "telephone_number": "310-267-9129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1316 W. Ontario St",
            "address_2": "Jones Hall, 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19140",
            "country_code": "US",
            "telephone_number": "800-836-7536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METKOWSKI",
        "first_name": "AFTON",
        "middle_name": "RENETTE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD470395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.