Peter A. Demaria Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD034505-E Issued in PA

Practice address

1700 N. Broad St. 2ND Floor
Philadelphia, PA 19121

Phone

(215) 204-7276

Fax

(215) 204-5419

NPI assigned

Nov 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  NPD (past)

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1114107430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N. BROAD ST. 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19121",
            "telephone_number": "215-204-7276",
            "fax_number": "215-204-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N. BROAD ST. 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19121",
            "telephone_number": "215-204-7276",
            "fax_number": "215-204-5419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 Liacouras Walk",
            "address_2": "5th Floor (66-09)",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191226026",
            "country_code": "US",
            "telephone_number": "215-204-7276",
            "fax_number": "215-204-5419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMARIA",
        "first_name": "PETER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "PA",
            "license": "MD-034505-E",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD034505-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "FO1897",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mario P Demarco, MD
• Michael Anthony Demarco, DO
• Samantha L Demarco, CRNP
• Kaitlin Demarest, MD
• Louis C. Demaria, MD
• Rita M. Demaria, PH.D., M.S.
• Cassandra Jeanne Demastus, NP
• Samuel Jacob Dematte, MD
• Mark Dematteo
• Ronald P Dematteo, MD

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.