NPIMap

Individual provider Active NPI

Mariusz A Wasik, MD

  • Anatomic Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1023053576
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD049675L Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111
Phone
(215) 728-3675
Fax
(215) 728-2848
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD049675L PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 728-3675

Other practice location 1

3400 Spruce Street
6 Founders
Philadelphia, PA 19104
Phone (215) 662-6503

Other practice location 2

3400 Spruce Street
6 Founders
Philadelphia, PA 19104
Phone (215) 662-6503

Other identifiers 1

IdentifierTypeStateIssuer
0015674870001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000578 PA Practitioner - Pathology 1456309707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan Inc 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-5030

Hospital & facility affiliations

  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Holy Redeemer Hospital and Medical Center Hospital, Meadowbrook, PA, CCN 390097

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD049675LPAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Mar 1, 2020 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Mar 1, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 6
Philadelphia, PA 19104
Phone (215) 615-0800

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 8

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 10

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1023053576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-728-3675",
            "fax_number": "215-728-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-728-3675",
            "fax_number": "215-728-2848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce Street",
            "address_2": "6 Founders",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-662-6503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Spruce Street",
            "address_2": "6 Founders",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19104",
            "country_code": "US",
            "telephone_number": "215-662-6503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASIK",
        "first_name": "MARIUSZ",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD049675L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015674870001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.