Individual provider Active NPI

Jennifer Marek, D.O.

  • Diagnostic Radiology Physician
  • Bryn Mawr, PA
National Provider Identifier
1093802522
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20A8232 Issued in CA
Practice address
130 S Bryn Mawr Ave
Bryn Mawr Hospital Radiology
Bryn Mawr, PA 19010-3121
Phone
(610) 429-0693
NPI assigned
Oct 6, 2006
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20A8232 CA Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr Hospital Radiology
Bryn Mawr, PA 19010-3121

Mailing address

405 Captains Way
Philadelphia, PA 19146-5209

Other identifiers 1

IdentifierTypeStateIssuer
00AX82320MedicaidCA

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8232CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Imaging Diagnostic Radiology Past Accepting new patients
Main Line Health Imaging LP Diagnostic Radiology Past Accepting new patients
Great Plains Imaging, LLC Diagnostic Radiology Past Accepting new patients
Radiology Associates of the Main Line P C Diagnostic Radiology Past Accepting new patients
Reliant Radiology Medical Group a Professional Corporation Diagnostic Radiology Past Accepting new patients
Memrad Medical Group Inc Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1093802522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CAPTAINS WAY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191465209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "address_2": "BRYN MAWR HOSPITAL RADIOLOGY",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "610-429-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAREK",
        "first_name": "JENNIFER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A8232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX82320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.