Individual provider Active NPI

Keith W Pratz, M.D.

  • Hematology & Oncology Physician
  • Philadelphia, PA
National Provider Identifier
1710966114
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD467231 Issued in PA
Practice address
3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127
Phone
(215) 615-0063
Fax
(215) 349-8144
NPI assigned
Jan 13, 2006
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X D0064483 MD
Hematology & Oncology Physician 207RH0003X MD467231 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
2 West
Philadelphia, PA 19104-5127
Phone (215) 615-0063

Other identifiers 2

IdentifierTypeStateIssuer
130187000MedicaidMN
417498400MedicaidMD

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
I20191007003217 PA Practitioner - Hematology/Oncology 5496806010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, shared by 15 NPIs, 3,433 clinicians
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 615-5858

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 615-5858

688 Downingtown Pike
West Chester, PA 19380-2226
Phone (484) 787-0200

Hospital & facility affiliations

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
D0064483MDMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Nov 18, 2019 Accepting new patients
University of Penn-Medical Group Hematology & Oncology CurrentSince Sep 9, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince Sep 9, 2019 Accepting new patients
Bih Radiologic Foundation Inc Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

3400 Civic Center Blvd
#3
Philadelphia, PA 19104
Phone (215) 662-2891

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3400 Civic Center Blvd
Fl 3W
Philadelphia, PA 19104

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

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

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

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

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1710966114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-0063",
            "fax_number": "215-349-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "2 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-0063",
            "fax_number": "215-349-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATZ",
        "first_name": "KEITH",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MD",
            "license": "D0064483",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD467231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130187000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417498400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.