NPIMap

Individual provider Active NPI

Mark A Testa, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1043205370
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S007357C Issued in PA
Practice address
2601 S 12TH St
Philadelphia, PA 19148-4303
Phone
(215) 389-6461
Fax
(215) 389-3726
NPI assigned
Sep 13, 2005
Last updated
Feb 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB06014000 NJ
Family Medicine Physician 207Q00000X 0S007357C PA Primary

Addresses

Primary practice location

2601 S 12TH St
Philadelphia, PA 19148-4303

Mailing address

1332 W Ritner St
Philadelphia, PA 19148-3537
Phone (215) 309-3222

Other identifiers 1

IdentifierTypeStateIssuer
0012858720001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071002000068 PA Practitioner - Family Practice 3577658848 Reassigns benefits to 2 organizations
I20120308000655 NJ Practitioner - Family Practice 3577658848 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philadelphia Heart, P CGroup PAC ID 7214108158, 2 clinicians
New Jersey Heart IncGroup PAC ID 8628242773, 3 clinicians

Practice addresses (Care Compare)

1332 W Ritner St
Philadelphia, PA 19148-3537
Phone (267) 319-1939

565 Egg Harbor Rd
Sewell, NJ 08080-2335
Phone (856) 553-6125

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
37.79 of 100Reported as individual
Quality
30
Improvement activities
0
Cost
77.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06014000NJMDFamily Medicine Physician
0S007357CPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Personal Care Physicians LLC Family Medicine CurrentSince Jan 1, 2018 Accepting new patients
New Jersey Heart, Inc. CurrentSince Oct 9, 2020 Accepting new patients
Philadelphia Heart, P C Family Medicine CurrentSince Jun 1, 2019 Accepting new patients
Visiting Physicians of the Delaware Valley LLC CurrentSince Apr 6, 2022 Accepting new patients
Evercare Hospice, Inc. Past Accepting new patients

Locations

538 Lippincott Dr
Bldg E
Marlton, NJ 08053
Phone (856) 489-0503

565 Egg Harbor Rd
Sewell, NJ 08080
Phone (856) 256-0600

1256 Haddonfield Berlin Rd
Voorhees, NJ 08043
Phone (215) 990-2157

3070 Bristol Pike
Ste 2-216
Bensalem, PA 19020
Phone (215) 364-8412

1332 W Ritner St
Philadelphia, PA 19148
Phone (215) 755-6143

1615 W Oregon Ave
Philadelphia, PA 19145
Phone (215) 334-2200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEFIBD/Endpoint/AEFIBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBJCD/Endpoint/HJBJCD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1043205370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 W RITNER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483537",
            "telephone_number": "215-309-3222",
            "fax_number": "267-930-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 S 12TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484303",
            "telephone_number": "215-389-6461",
            "fax_number": "215-389-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESTA",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB06014000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "0S007357C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012858720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.