Individual provider Active NPI

Mark Hysell, DO

  • Vascular & Interventional Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1174513105
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
OS008550L Issued in PA
Practice address
Broad & Vine St S
Philadelphia, PA 19102
Phone
(215) 762-4312
Fax
(215) 762-8656
NPI assigned
Oct 21, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X OS008550L PA Primary

Addresses

Primary practice location

Broad & Vine St S
Philadelphia, PA 19102

Mailing address

Broad and Vine St S
Ms 310
Philadelphia, PA 19102
Phone (215) 762-4312

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bsi Acquisition, LP Past Accepting new patients
Rittenhouse Imaging Center, LLC 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, 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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174513105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROAD AND VINE ST S",
            "address_2": "MS 310",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-4312",
            "fax_number": "215-762-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROAD & VINE ST S",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-4312",
            "fax_number": "215-762-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYSELL",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "OS008550L",
            "primary": true
        }
    ],
    "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 Jul 13, 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.

Verify at the official NPI Registry.