Active NPI
Patrick V Marasco Jr., MD
- Plastic and Reconstructive Surgery Physician
- North Andover, MA
National Provider Identifier
1225020951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 56106
- Practice address
- 43 High St
Suite 110B
North Andover, MA 01845-2646 - Phone
- (978) 687-3242
- Fax
- (978) 208-8414
- NPI assigned
- Aug 18, 2005
- 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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 56106 | MA | Primary |
Addresses
Primary practice location
43 High St
Suite 110B
North Andover, MA 01845-2646
Mailing address
43 High St
Suite 110B
North Andover, MA 01845-2646
Phone (978) 687-3242
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225020951 | Other | MA | MEDICARE MD |
| 706025 | Other | MA | TUFTS |
| J05874 | Other | MA | BLUE SHIELD |
| 3006620 | Medicaid | MA | |
| M20120 | Other | MA | MEDICARE CORP |
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 Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1225020951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 HIGH ST",
"address_2": "SUITE 110B",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018452646",
"telephone_number": "978-687-3242",
"fax_number": "978-208-8414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 HIGH ST",
"address_2": "SUITE 110B",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018452646",
"telephone_number": "978-687-3242",
"fax_number": "978-208-8414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARASCO",
"first_name": "PATRICK",
"middle_name": "V",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "MA",
"license": "56106",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE MD",
"identifier": "1225020951",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "706025",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "J05874",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3006620",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE CORP",
"identifier": "M20120",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.