Active NPI
Mark Leonard Bagarazzi, MD
- Pediatric Infectious Diseases Physician
- Conshohocken, PA
National Provider Identifier
1538579263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- MD047811L
- Practice address
- 280 Garrison Way
Conshohocken, PA 19428-2546 - Phone
- (610) 527-8997
- NPI assigned
- May 2, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Infectious Diseases Physician | 2080P0208X | MD047811L | PA | Primary |
Addresses
Primary practice location
280 Garrison Way
Conshohocken, PA 19428-2546
Mailing address
280 Garrison Way
Conshohocken, PA 19428-2546
Phone (610) 527-8997
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD047811L | PA | MD | Pediatric Infectious Diseases Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1538579263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 GARRISON WAY",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "194282546",
"telephone_number": "610-527-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 GARRISON WAY",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "194282546",
"telephone_number": "610-527-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGARAZZI",
"first_name": "MARK",
"middle_name": "LEONARD",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-02",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "PA",
"license": "MD047811L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conshohocken, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.