Mario J. Sebastianelli, MD PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD006983E Issued in PA

Legal business name

MARIO J. SEBASTIANELLI, MD PC

Practice address

1416 Monroe Ave
Ste 206
Dunmore, PA 18509-2477

Phone

(570) 347-5212

Fax

(570) 346-4814

NPI assigned

Jul 13, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Mario J. Sebastianelli, M.D.NPI 1972501872

Title

Owner

Phone

(570) 347-5212

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario J Sebastianelli, MD

  • Nephrology Physician
  • Dunmore, PA
  • NPI 1972501872
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1194723007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 MONROE AVE",
            "address_2": "STE 206",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185092477",
            "telephone_number": "570-347-5212",
            "fax_number": "570-346-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 MONROE AVE",
            "address_2": "STE 206",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185092477",
            "telephone_number": "570-347-5212",
            "fax_number": "570-346-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO J. SEBASTIANELLI, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "SEBASTIANELLI",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-347-5212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD006983E",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD006983E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0669080",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Maida, PA-C
• Anthony Michael Malec, CRS, CPS
• Erin Christy Maloney, L.S.W.
• Michael Anthony Mandarano, D.O.
• Sofia Mansurova, LMFT
• Peter A Mataloni, D.M.D.
• Rae Beth Mattioli, OTR/L
• Maura Pinto
• Kenneth B Mayers, DC
• Mary Ann McDonald, M.D.

• Nephrology Physician in Dunmore, PA
• Providers in Dunmore, PA by specialty
• Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.