Individual provider Active NPI

Kenneth Rothstein, MD

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1790753317
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD044179E Issued in PA
Practice address
3400 Civic Center Blvd FL 4
Philadelphia, PA 19104
Phone
(215) 349-8222
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Hepatology Physician 207RT0003X MD044179E PA
Gastroenterology Physician 207RG0100X MD044179E PA Primary
Internal Medicine Physician 207R00000X MD044179E PA

Addresses

Primary practice location

3400 Civic Center Blvd FL 4
Philadelphia, PA 19104

Mailing address

3400 Civic Center Blvd FL 4
Philadelphia, PA 19104-5127
Phone (215) 349-8222

Other practice location 1

3400 Spruce St
2 Dulles
Philadelphia, PA 19104
Phone (215) 349-8222

Other identifiers 1

IdentifierTypeStateIssuer
001237178MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070905000072 NJ Practitioner - Gastroenterology 4789777905 Reassigns benefits to 2 organizations
I20080508000487 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 4789777905 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Emory University School of Medicine, 1986
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
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, shared by 7 NPIs, 793 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 349-8222

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

5 Plainsboro Rd
Plainsboro, NJ 08536-1915
Phone (215) 662-6200

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Doylestown Hospital Hospital, Doylestown, PA, CCN 390203
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD044179EPAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Internal Medicine Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC Current Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Apr 1, 2022 Accepting new patients
University of Penn-Medical Group Gastroenterology Current Accepting new patients
University of Penn - Medical Group Internal Medicine CurrentSince Jul 14, 2018 Accepting new patients
University of Penn - Medical Group Gastroenterology CurrentSince Jan 1, 2018 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 29, 2018 Accepting new patients
University of Penn-Medical Group Internal Medicine CurrentSince Feb 17, 2018 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. Internal Medicine CurrentSince Nov 29, 2018 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1865 Route 70 E
Ste 210
Cherry Hill, NJ 08003
Phone (856) 427-4336

3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113

5 Plainsboro Rd
Ste 450
Plainsboro, NJ 08536
Phone (609) 477-3025

155 Medical Center Way
Fl 3
Somers Point, NJ 08244
Phone (609) 365-6239

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

1501 N Cedar Crest Blvd
Ste 110
Allentown, PA 18104
Phone (610) 821-2828

1501 Lansdowne Ave
Fl 1
Darby, PA 19023
Phone (610) 237-2531

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

554 N Duke St
Fl 3
Lancaster, PA 17602
Phone (717) 544-1960

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

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

3400 Civic Center Blvd
Fl 4
Philadelphia, PA 19104
Phone (215) 662-3580

3400 Spruce St
Fl 3
Philadelphia, PA 19104

3400 Civic Center Blvd
#4
Philadelphia, PA 19104
Phone (215) 614-1618

PO B0x 824320
Philadelphia, PA 19182

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

777 Township Line Rd
Yardley, PA 19067
Phone (215) 399-6011

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1790753317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-349-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-349-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_2": "2 Dulles",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-349-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROTHSTEIN",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "PA",
            "license": "MD044179E",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD044179E",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD044179E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001237178",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.