Dr Theodore Willis Laetsch Jr, MD in Philadelphia, PA

Dr Theodore Willis Laetsch Jr, MD is a medicare enrolled "Pediatrics" physician in Philadelphia, Pennsylvania. His current practice location is 3401 Civic Center Blvd, Philadelphia, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (267) 425-0126.

Dr Theodore Willis Laetsch Jr is licensed to practice in Pennsylvania (license number MD436327) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1154477834.

Contact Information

	Dr Theodore Willis Laetsch Jr, MD
	3401 Civic Center Blvd, Philadelphia, PA 19104-4319
	(267) 425-0126
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Theodore Willis Laetsch Jr
Gender	Male
Speciality	Pediatrics
Location	3401 Civic Center Blvd, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154477834
Provider Enumeration Date: 01/26/2007
Last Update Date: 02/19/2024

Medicare PECOS Information:

PECOS PAC ID: 9537227590
Enrollment ID: I20120511000159

Medical Identifiers

Medical identifiers for Dr Theodore Willis Laetsch Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154477834	NPI	-	NPPES
13339796	Medicaid	CO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0207X	Pediatrics - Pediatric Hematology-oncology	P6853 (Texas)	Secondary
2080P0207X	Pediatrics - Pediatric Hematology-oncology	MD436327 (Pennsylvania)	Secondary
208000000X	Pediatrics	MD436327 (Pennsylvania)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Theodore Willis Laetsch Jr allows following entities to bill medicare on his behalf.

Entity Name	Childrens Health Care Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598869059 PECOS PAC ID: 1355253527 Enrollment ID: O20040216001108

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Theodore Willis Laetsch Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Theodore Willis Laetsch Jr, MD 3401 Civic Center Blvd Ste M975, Philadelphia, PA 19104-4319 Ph: () -	Dr Theodore Willis Laetsch Jr, MD 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 Ph: (267) 425-0126

Reviews and Comments

Pediatrics Doctors in Philadelphia, PA

Aaron Dorfman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3401 Civic Center Blvd, Children's Hospital Of Philadelphia - Cardiology, Philadelphia, PA 19104 Phone: 215-590-4040 Fax: 267-425-9800
Brian Lestini, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 34th & Civic Center Blvd, Children's Hospital Of Philadelphia, Philadelphia, PA 19104 Phone: 215-590-1000 Fax: 215-590-2204
Elizabeth Foglia, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 8 Ravdin, Philadelphia, PA 19104 Phone: 215-662-3228 Fax: 215-349-8831
Dr. Katharine Taylor Levinson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 34th St And Civic Ctr Blvd, Philadelphia, PA 19104 Phone: 215-590-1000 Fax: 215-481-8795
Ms. Amman Hassan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5501 Old York Rd, Philadelphia, PA 19141 Phone: 215-456-3810
Geoffrey Libarnes Bajwa, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 160 E Erie Ave, Philadelphia, PA 19134 Phone: 215-427-5000
Helen Marie Stanley, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3401 Civic Center Blvd Rm 55, Philadelphia, PA 19104 Phone: 215-590-1220

Dr Theodore Willis Laetsch Jr, MD - Medicare Pediatrics in Philadelphia, PA