NPIMap

Individual provider Active NPI

Marylena Rose Mizerak, MD

  • Internal Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1326614116
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD486010 Issued in PA
Practice address
1540 Alexandra LN
Harrisburg, PA 17110-3656
Phone
(717) 798-3363
Fax
(717) 798-3364
NPI assigned
Jun 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD486010 PA Primary

Addresses

Primary practice location

1540 Alexandra LN
Harrisburg, PA 17110-3656

Mailing address

1540 Alexandra LN
Harrisburg, PA 17110-3656
Phone (717) 798-3363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912000829 PA Practitioner - Internal Medicine 3678975901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

1540 Alexandra LN
Harrisburg, PA 17110-3656
Phone (717) 798-3363

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Lancaster, PA, CCN 397401
  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Penn State Health Hampden Medical Center Hospital, Enola, PA, CCN 390336

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD486010PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1326614116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 ALEXANDRA LN",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103656",
            "telephone_number": "717-798-3363",
            "fax_number": "717-798-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 ALEXANDRA LN",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171103656",
            "telephone_number": "717-798-3363",
            "fax_number": "717-798-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZERAK",
        "first_name": "MARYLENA",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD486010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.