Kenneth A Witterholt, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD044526L Issued in PA

Practice address

915 Old Fern Hill Rd
Building B, Suite 201
West Chester, PA 19380-4269

Phone

(610) 436-6696

Fax

(610) 430-6023

NPI assigned

Mar 14, 2006

Last updated

Jan 18, 2011By the provider in NPPES

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 1

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

General Surgery

Education

George Washington University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Care Associates of the University of Pennsylvania Health.Group PAC ID 4688588866, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
• Chester County Hospital Hospital, West Chester, PA, CCN 390179
• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment Care Compare group NPD
• Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
  • NPI 1649940107
  NPD
• Clinical Care Associates of the University of Pennsylvania Health Syst

  • Hospitalist Physician
  • Bala Cynwyd, PA
  • NPI 1790737468

  Surgery

  NPD
• Surgical Specialists, P.C.

  • Vascular Surgery Physician
  • Paoli, PA
  • NPI 1780650465
  NPD
• Chester County Hospital

  • General Acute Care Hospital
  • West Chester, PA
  • NPI 1356333579
  NPD (past)

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

• Chester County Hospital

  • General Acute Care Hospital
  • West Chester, PA
  • NPI 1356333579
  Care Compare affiliation
• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Main Line Hospitals, Inc.

  dba Paoli Hospital

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Presbyterian Medical Center of the University of Pennsylvania Health S

  dba Penn Care at Home

  • Home Health Agency
  • Bala Cynwyd, PA
  • NPI 1992746366
  Care Compare affiliation
• Trustees of the University of Pennsylvania

  dba Hospital of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1568431534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD",
            "address_2": "BUILDING B, SUITE 201",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-436-6696",
            "fax_number": "610-430-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLD FERN HILL RD",
            "address_2": "BUILDING B, SUITE 201",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804269",
            "telephone_number": "610-436-6696",
            "fax_number": "610-430-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTERHOLT",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD044526L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012483500003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Matthew P Wlostowski, CRNA
• Catrina Marie Wolfe, PA-C
• Heather Wolfe

• Surgery Physician in West Chester, PA
• Providers in West Chester, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.