Tibor Ketzan, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD021936E Issued in PA

Practice address

720 Blackburn Road
Sewickley Valley Hospital
Sewickley, PA 15143

Phone

(412) 749-7127

Fax

(412) 749-4268

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962417626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 BLACKBURN ROAD",
            "address_2": "SEWICKLEY VALLEY HOSPITAL",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "15143",
            "telephone_number": "412-749-7127",
            "fax_number": "412-749-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 BLACKBURN ROAD",
            "address_2": "SEWICKLEY VALLEY HOSPITAL",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "15143",
            "telephone_number": "412-749-7127",
            "fax_number": "412-749-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETZAN",
        "first_name": "TIBOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD021936E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "0024749",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE ADVANTRA",
            "identifier": "5803",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0994356",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCS SECURITY BLU",
            "identifier": "159417",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1007226",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "23215676400",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO WORKERS COMP",
            "identifier": "23215676400",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "P003957",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1265992",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W VIRGINIA WORKERS COMP",
            "identifier": "23215676400",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine C Ke, MD
• Carson Kegel, AU.D.
• Brian James Kelly, M.D.
• Darby Victoria Kern, DC
• John R. Kerr, O.D.
• Keystone Rehabilitation Systems Inc
• Keystone Rehabilitation Systems, Inc.
• Tessa Kimmy, DPT
• Robert E King, DMD
• Janene Hecker Klein, M.D.

• All providers in Sewickley, PA
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.