Individual provider Active NPI

Amy Beatty Marzolf, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1295009512
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP011776 Issued in PA
Practice address
3400 Civic Center Blvd
East Pavilion, 2ND Floor
Philadelphia, PA 19104-5127
Phone
(215) 615-4949
NPI assigned
Mar 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP011776 PA Primary

Addresses

Primary practice location

3400 Civic Center Blvd
East Pavilion, 2ND Floor
Philadelphia, PA 19104-5127

Mailing address

3400 Civic Center Blvd
East Pavilion, 2ND Floor
Philadelphia, PA 19104-5127
Phone (215) 615-4949

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000430 PA Practitioner - Nurse Practitioner 6204096878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 615-4949

3400 Civic Ctr Blvd W Pavillion
Penn Vad Transplant Perelman
Philadelphia, PA 19104-5127
Phone (215) 662-2019

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-9801

51 N 39TH St HVP 2ND FL
Div of Cardiology
Philadelphia, PA 19104-2640
Phone (215) 662-9010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Mar 5, 2012 Accepting new patients
University of Penn - Medical Group CurrentSince Mar 5, 2012 Accepting new patients

Locations

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

3400 Civic Center Blvd
Ste 2E
Philadelphia, PA 19104
Phone (215) 615-0820

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1295009512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "EAST PAVILION, 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CIVIC CENTER BLVD",
            "address_2": "EAST PAVILION, 2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045127",
            "telephone_number": "215-615-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOLF",
        "first_name": "AMY",
        "middle_name": "BEATTY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP011776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.