Individual provider Active NPI

Mark Rizzi, M.D.

  • Otolaryngology Physician
  • Philadelphia, PA
National Provider Identifier
1003006248
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD430727 Issued in PA
Practice address
34TH & Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4399
Phone
(215) 590-3440
Fax
(215) 590-3986
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD430727 PA Primary
Pediatric Otolaryngology Physician 207YP0228X MD430727 PA

Addresses

Primary practice location

34TH & Civic Center Blvd
Children'S Hospital of Philadelphia
Philadelphia, PA 19104-4399

Mailing address

100 East Penn Square
The Wanamaker Building 9TH FL
Philadelphia, PA 19107-4306
Phone (267) 425-9538

Other identifiers 1

IdentifierTypeStateIssuer
102158035-0001MedicaidPA

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
I20080717000337 PA Practitioner - Otolaryngology 4789757147 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD430727PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates LTD Current Accepting new patients
Children'S Surgical Associates LTD CurrentSince Apr 12, 2025 Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients
Children'S Surgical Associates LTD Otolaryngology Past Accepting new patients
Children'S Surgical Associates LTD Past Accepting new patients

Locations

100 E Penn Sq
Bldg 9TH
Philadelphia, PA 19107
Phone (267) 425-9538

3401 Civic Center Blvd
Ste 34
Philadelphia, PA 19104

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1003006248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST PENN SQUARE",
            "address_2": "THE WANAMAKER BUILDING 9TH FL",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074306",
            "telephone_number": "267-425-9538",
            "fax_number": "267-425-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34TH & CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044399",
            "telephone_number": "215-590-3440",
            "fax_number": "215-590-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZI",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD430727",
            "primary": true
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "PA",
            "license": "MD430727",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102158035-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.