Active NPI
Mark Levy, MD
- Internal Medicine Physician
- Paoli, PA
National Provider Identifier
1194765297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD018364E
- Practice address
- 255 W Lancaster Ave
Suite 200
Paoli, PA 19301-1763 - Phone
- (610) 644-2255
- Fax
- (610) 644-8738
- NPI assigned
- Jun 7, 2006
- Last updated
- Nov 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD018364E | PA | Primary |
Addresses
Primary practice location
255 W Lancaster Ave
Suite 200
Paoli, PA 19301-1763
Mailing address
255 W Lancaster Ave
Suite 200
Paoli, PA 19301-1763
Phone (610) 644-2255
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LE047138 | Other | PA | HIGHMARK |
| 54012 | Other | PA | AETNAE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110216000668 | PA | Practitioner - Internal Medicine | 7911188420 | Practice locations: Paoli, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Healthcare | Internal Medicine | 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, 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": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1194765297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W LANCASTER AVE",
"address_2": "SUITE 200",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011763",
"telephone_number": "610-644-2255",
"fax_number": "610-644-8738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W LANCASTER AVE",
"address_2": "SUITE 200",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011763",
"telephone_number": "610-644-2255",
"fax_number": "610-644-8738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVY",
"first_name": "MARK",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD018364E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "LE047138",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNAE",
"identifier": "54012",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paoli, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.