Individual provider Active NPI

Maria Gabriela Pazan Avellan, DO

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003751959
Registry record updated Apr 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OT025155 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5189
Phone
(800) 836-7536
NPI assigned
Apr 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT025155 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5189

Mailing address

1103 Quinard CT
Ambler, PA 19002-6010

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
I20260526003537 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6204306723

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT025155PAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777161600000",
    "number": "1003751959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 QUINARD CT",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190026010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "800-836-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZAN AVELLAN",
        "first_name": "MARIA",
        "middle_name": "GABRIELA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-26",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT025155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.