Ida Mazzone MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME74663 Issued in FL

Legal business name

IDA MAZZONE MD PA

Practice address

6101 Pine Ridge Rd
Naples, FL 34119-3900

Phone

(239) 348-4400

Fax

(239) 236-1300

NPI assigned

Feb 19, 2009

Last updated

Feb 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ida Mazzone, MDNPI 1043267644

Title

President

Phone

(239) 465-9722

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ida M Mazzone, MD

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1043267644
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1205075900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 IMMOKALEE RD",
            "address_2": "#149",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101445",
            "telephone_number": "239-465-9722",
            "fax_number": "239-236-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900",
            "telephone_number": "239-348-4400",
            "fax_number": "239-236-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDA MAZZONE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "MAZZONE",
        "authorized_official_first_name": "IDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-465-9722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME74663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Naples, FL
• Providers in Naples, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.