Active NPI
Hailey Samantha Marcus, PA-C
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1104605542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OA006616
- Practice address
- 2 Penn Blvd Ste 108
Philadelphia, PA 19144-1402 - Phone
- (215) 842-0406
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OA006616 | PA | Primary |
| Physician Assistant | 363A00000X | PA9122077 | FL |
Addresses
Primary practice location
2 Penn Blvd Ste 108
Philadelphia, PA 19144-1402
Mailing address
631 Wises Mill Rd
Philadelphia, PA 19128-3118
Phone (267) 421-4589
Other practice location 1
12871 Citrus Plaza Dr
Tampa, FL 33625-3010
Phone (813) 471-4445
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA006616 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| True North Medical Group, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1104605542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 WISES MILL RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191283118",
"telephone_number": "267-421-4589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 PENN BLVD STE 108",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191441402",
"telephone_number": "215-842-0406"
}
],
"practiceLocations": [
{
"address_1": "12871 Citrus Plaza Dr",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336253010",
"country_code": "US",
"telephone_number": "813-471-4445",
"fax_number": "813-343-5022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARCUS",
"first_name": "HAILEY",
"middle_name": "SAMANTHA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "OA006616",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9122077",
"primary": false
}
],
"identifiers": [],
"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 Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.