Individual provider Active NPI

Marluce Bibbo, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
National Provider Identifier
1083622658
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD046632L Issued in PA
Practice address
132 S 10TH St
2ND Floor, 285K
Philadelphia, PA 19107-5244
Phone
(215) 503-5642
Fax
(215) 503-4817
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD046632L PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD046632L PA Primary

Addresses

Primary practice location

132 S 10TH St
2ND Floor, 285K
Philadelphia, PA 19107-5244

Mailing address

132 S 10TH St
2ND Floor, 285K
Philadelphia, PA 19107-5244
Phone (215) 503-5642

Other identifiers 2

IdentifierTypeStateIssuer
001392470MedicaidPA
001392470MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Past Accepting new patients
Jefferson University Physicians Past Accepting new patients

Organizations & group practices 2

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1083622658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "2ND FLOOR, 285K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-503-5642",
            "fax_number": "215-503-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "2ND FLOOR, 285K",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-503-5642",
            "fax_number": "215-503-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBBO",
        "first_name": "MARLUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "PA",
            "license": "MD046632L",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD046632L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001392470",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001392470",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.