Mazzoni Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAZZONI CENTER

Practice address

1348 Bainbridge St
Philadelphia, PA 19147-1810

Phone

(215) 563-0652

Fax

(215) 563-0664

NPI assigned

Nov 1, 2006

Last updated

Sep 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alecia ManleyNPI 1780226050

Title

Coo

Phone

(215) 563-0652

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• PCHA Former legal business name

Electronic endpoints 12

Medicare fee-for-service enrollment

Enrolled in PA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477631307. Details of each certification follow.

• CCN D31032 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN D31032

Legal name

MAZZONI CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 18, 2025

Last certification

Mar 18, 2025

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 16, 1981 in PA

Enrollment address

1348 Bainbridge St
Philadelphia, PA 19147-1810

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: alexander.krausman.1@2819.direct.athenahealth.com
• Direct secure messaging: ash.robbins.1@2819.direct.athenahealth.com
• Direct secure messaging: caroline.cylkowski.1@2819.direct.athenahealth.com
• Direct secure messaging: dustin.latimer.1@2819.direct.athenahealth.com
• Direct secure messaging: hilary.rosenstein.1@2819.direct.athenahealth.com
• Direct secure messaging: kasey.benchimol.1@2819.direct.athenahealth.com
• Direct secure messaging: mark.watkins.1@2819.direct.athenahealth.com
• Direct secure messaging: nancy.brisbon.1@2819.direct.athenahealth.com
• Direct secure messaging: sierra.brittingham.1@2819.direct.athenahealth.com

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Stacey Trooskin, MD

  • Infectious Disease Physician
  • Philadelphia, PA
  • NPI 1073716296

  Operational/Managerial Control

  CMS ownership

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christiian Storm Credle, PSYD

  • Psychologist
  • Sharon Hill, PA
  • NPI 1316552102
  Medicare reassignment Care Compare group NPD
• Julia L Dejoseph, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1679776926
  Medicare reassignment Care Compare group NPD
• Janet Hines, MD

  • Infectious Disease Physician
  • Philadelphia, PA
  • NPI 1134159254
  Medicare reassignment Care Compare group NPD
• Hilary Alexis Rosenstein, MD

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1063799351
  Medicare reassignment Care Compare group NPD
• Rachel Springer, MD

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1922503853
  Medicare reassignment Care Compare group NPD
• Mark Thomas Watkins, DO

  • Adult Medicine Physician
  • Philadelphia, PA
  • NPI 1336226166
  Medicare reassignment Care Compare group NPD
• Jennifer L Aldrich, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1386719979
  Medicare reassignment NPD
• David L. Beckmann, MD, MPH

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1346504800
  Medicare reassignment NPD
• Casey Benchimol, CRNP

  • Women's Health Nurse Practitioner
  • Philadelphia, PA
  • NPI 1790349835
  Medicare reassignment NPD
• Mayeso Chithambo

  • General Practice Registered Nurse
  • Camp Hill, PA
  • NPI 1629746136
  Medicare reassignment NPD
• Lucy Gleysteen

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1003471301
  Medicare reassignment NPD
• Elyse Hibbs, LCSW

  • Clinical Social Worker
  • Southampton, PA
  • NPI 1205419298
  Medicare reassignment NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1477631307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 BAINBRIDGE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471810",
            "telephone_number": "215-563-0652",
            "fax_number": "215-563-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 BAINBRIDGE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471810",
            "telephone_number": "215-563-0652",
            "fax_number": "215-563-0664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 Locust Street",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074123",
            "country_code": "US",
            "telephone_number": "215-563-0658",
            "fax_number": "215-563-0662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Locust St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075409",
            "country_code": "US",
            "telephone_number": "215-985-9206",
            "fax_number": "215-923-0365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAZZONI CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "MANLEY",
        "authorized_official_first_name": "ALECIA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "215-563-0652"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "807382",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007555740014",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "caroline.cylkowski.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nancy.brisbon.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dustin.latimer.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.watkins.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hilary.rosenstein.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ash.robbins.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sierra.brittingham.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kasey.benchimol.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexander.krausman.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.aldrich.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.wilburn.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jamie.buth.1@2819.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "1348 Bainbridge St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191471810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PCHA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PCHA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Pamela Mazzeo, M.D.
• Emma L Mazzio, MD
• Maria Mazzocchi
• MC Mazzocchi
• Mazzoni Center
• Linda Mazzotta
• Madeline Grace Mazzotta, LSW
• Maria Mazzotti, DO
• MB Integrative Medicine LLC
• Ezinne Mbata, COTA

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, 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 Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.