Mary M. Decaro, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD041724L Issued in PA

Practice address

1088 W Baltimore Pike
Suite 2208
Media, PA 19063-5146

Phone

(484) 565-8500

Fax

(610) 280-1595

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1275533689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE",
            "address_2": "SUITE 2208",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635146",
            "telephone_number": "484-565-8500",
            "fax_number": "610-280-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE",
            "address_2": "SUITE 2208",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635146",
            "telephone_number": "484-565-8500",
            "fax_number": "610-280-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARO",
        "first_name": "MARY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD041724L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Davidson
• Alexis Davis, RBT
• Krystalyn T Davis
• Daya Healthcare Solutions, LLC
• Heather De Vries
• Del-Val Foot & Ankle P C
• Janine Dela Cruz, BCBA, LBS, MA
• Delaware County Juvenile Detention Center Family Planning
• Delaware County Professional Services, Inc
• Delaware County Rheumatology, PC

• Family Medicine Physician in Media, PA
• Providers in Media, 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 Feb 19, 2016; 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.