Individual provider Active NPI

Paula Borland Marcinkevich, AUD

  • Audiologist
  • Philadelphia, PA
National Provider Identifier
1396939948
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT000322L Issued in PA
Practice address
925 Chestnut St
Philadelphia, PA 19107-4216
Phone
(215) 955-6784
Fax
(215) 923-4532
NPI assigned
Aug 28, 2007
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 41YA00091800 NJ
Audiologist 231H00000X AT000322L PA Primary

Addresses

Primary practice location

925 Chestnut St
Philadelphia, PA 19107-4216

Mailing address

925 Chestnut Street
Philadelphia, PA 19107
Phone (215) 955-6784

Other practice location 1

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 488-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1396939948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-6784",
            "fax_number": "215-923-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074216",
            "telephone_number": "215-955-6784",
            "fax_number": "215-923-4532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Chapel Ave W",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022048",
            "country_code": "US",
            "telephone_number": "856-488-6500",
            "fax_number": "856-922-5109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCINKEVICH",
        "first_name": "PAULA",
        "middle_name": "BORLAND",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00091800",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT000322L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.