Constantine D Mavroudis, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD453196 Issued in PA

Practice address

3400 Spruce St
4 Maloney
Philadelphia, PA 19104-4206

Phone

(215) 662-6157

NPI assigned

Jun 6, 2012

Last updated

Jul 30, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in PA, TX2 enrollments

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 2

Specialty

Thoracic Surgery

Education

Loyola University of Chicago, Stritch School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dell Children's Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943
  Medicare reassignment Care Compare group NPD
• Children's Surgical Associates LTD

  • Plastic Surgery Physician
  • Philadelphia, PA
  • NPI 1326117185
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment NPD
• Children's Surgical Associates LTD

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1821177395
  NPD
• University of Penn-Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Philadelphia, PA
  • NPI 1700274727
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD
• Dell Children's Medical Group

  dba Dell Children's Medical Group Sleep Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1316208218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "4 MALONEY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "4 MALONEY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVROUDIS",
        "first_name": "CONSTANTINE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD453196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Mautone, PH.D.
• Nazira Mavlyanova
• Amanda Mavricos
• Maria Anna Mavrommatis, BA
• Steven Mavros, LOM
• Ashley E Mawhinney, DO
• Lisa Mawhinney
• Max Home Health Care LLC
• Maxcare Chiropractic LLC
• John Maxham

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.