Ralph David Mazzochetti, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS005877L Issued in PA

Practice address

232 Sunbury St
Minersville, PA 17954-1346

Phone

(570) 544-4590

Fax

(570) 544-9686

NPI assigned

Feb 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1265405294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-4590",
            "fax_number": "570-544-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-4590",
            "fax_number": "570-544-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOCHETTI",
        "first_name": "RALPH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS005877L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001133039",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Ledezma
• Cynthia L Lubinsky, DO
• Ellen NMN Mace, DO
• Magnolia Health Group
• Carl Paul Makuta, D.C.
• Vanessa L. McCormick, M.S. CCC-SLP
• Kevin M McNamara, BCBA
• Med-Way Medical Supply
• Minerss Specialty Pharmacy Inc
• Minersville Area School District

• Family Medicine Physician in Minersville, PA
• Providers in Minersville, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.

Verify at the official NPI Registry.