NPIMap

Individual provider Active NPI

Marisa Cevasco, M.D., M.P.H

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Philadelphia, PA
National Provider Identifier
1104098169
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD467275 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-2050
Fax
(215) 615-0829
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 288226 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD467275 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2050

Other identifiers 1

IdentifierTypeStateIssuer
288226OtherNYNYS LICENSE

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
I20190530000156 PA Practitioner - Thoracic SurgeryPractitioner - General Surgery 9032357306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: General Surgery
Education
Vanderbilt University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2050

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Penn Medicine Home Health Princeton Health Home health agency, Princeton, NJ, CCN 317045
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)40
Pacemaker insertion or repair1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2019 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Columbia Doctors of New Jersey, P. C. Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

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

800 Walnut St
Fl 9
Philadelphia, PA 19107
Phone (215) 829-5027

230 W Washington Sq
Philadelphia, PA 19106
Phone (215) 829-5064

145 King of Prussia Rd
Ste 101
Radnor, PA 19087
Phone (215) 662-2956

600 E Marshall St
Ste 303
West Chester, PA 19380
Phone (610) 436-1584

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1104098169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2050",
            "fax_number": "215-615-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-2050",
            "fax_number": "215-615-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEVASCO",
        "first_name": "MARISA",
        "credential": "M.D., M.P.H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "288226",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD467275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "288226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.