Individual provider Active NPI

Stacey Beth Prenner, MD

  • Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1992098859
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD460034 Issued in PA
Practice address
3400 Civic Center Blvd FL 4
Philadelphia, PA 19104-5127
Phone
(215) 349-8222
NPI assigned
May 25, 2011
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD460034 PA
Gastroenterology Physician 207RG0100X MD460034 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd FL 4
Philadelphia, PA 19104-5127

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 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
I20170616000054 PA Practitioner - GastroenterologyPractitioner - Internal Medicine 7810265832 Reassigns benefits to 1 organization
I20190819003269 DE Practitioner - Gastroenterology 7810265832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Hahnemann University College of Medicine, 2011
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

Practice addresses (Care Compare)

537 Stanton Christiana Rd
FL 2
Newark, DE 19713-2146
Phone (215) 662-6200

777 Township Line Rd
Yardley, PA 19067-5552
Phone (215) 349-8222

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy26
Upper gastrointestinal (GI) endoscopy for acid reflux12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD460034PAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Gastroenterology CurrentSince Jun 10, 2024 Accepting new patients
University of Penn - Medical Group Gastroenterology CurrentSince Jul 1, 2017 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

537 Stanton Christiana Rd
Fl 2
Newark, DE 19713

537 Stanton Christiana Rd
Newark, DE 19713
Phone (302) 225-2380

3400 Spruce St
Fl 3
Philadelphia, PA 19104

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

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

3400 Civic Center Blvd
#4W
Philadelphia, PA 19104
Phone (215) 662-2300

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

145 King of Prussia Rd
Ste 205
Wayne, PA 19087
Phone (610) 902-4858

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

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 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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1992098859",
    "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": "191045127",
            "telephone_number": "215-349-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENNER",
        "first_name": "STACEY",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD460034",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD460034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.