NPIMap

Individual provider Active NPI

Marino D Mallozzi, MD

  • Internal Medicine Physician
  • Ephrata, PA
National Provider Identifier
1558377648
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD056528L Issued in PA
Practice address
446 N Reading Rd
Suite 301
Ephrata, PA 17522-9802
Phone
(717) 733-6546
Fax
(717) 733-6010
NPI assigned
Jul 31, 2006
Last updated
Apr 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD056528L PA Primary
Hospitalist Physician 208M00000X MD056528L PA

Addresses

Primary practice location

446 N Reading Rd
Suite 301
Ephrata, PA 17522-9802

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 733-6546

Other practice location 1

169 Martin Ave
Ephrata, PA 17522-1724
Phone (717) 721-4740

Other identifiers 3

IdentifierTypeStateIssuer
0015302170001MedicaidPA
783382OtherPABLUE SHIELD
P00269502OtherPARAILROAD MEDICARE

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
I20050808000670 PA Practitioner - Internal Medicine 3274562525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

446 N Reading Rd
Suite 301
Ephrata, PA 17522-9802
Phone (717) 733-6456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD056528LPAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Current Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients
Ephrata Community Hospital Current Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients
Wellspan Medical Group Current Accepting new patients
United Zion Retirement Community Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

175 Martin Ave
Ste 125
Ephrata, PA 17522
Phone (717) 812-4602

175 Martin Ave
Ste 355
Ephrata, PA 17522
Phone (717) 733-4667

4131 Oregon Pike
#C
Ephrata, PA 17522

446 N Reading Rd
Ephrata, PA 17522
Phone (717) 738-4334

446 N Reading Rd
Ste 301
Ephrata, PA 17522
Phone (717) 733-6546

808 Pleasantview Dr
Ephrata, PA 17522
Phone (717) 733-6518

435 S Kinzer Ave
New Holland, PA 17557
Phone (717) 351-2419

435 S Kinzer Ave
Ste 10
New Holland, PA 17557
Phone (717) 351-2454

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Interoperability endpoints

  • Direct secure messaging: mmallozzi@direct-address.net
  • Direct secure messaging: mmallozzi14052@wellspan.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wellspan Internal MedicineLititz, PA, CCN 395631 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 29, 2015
Jun 29, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1558377648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-733-6546",
            "fax_number": "717-733-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 N READING RD",
            "address_2": "SUITE 301",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229802",
            "telephone_number": "717-733-6546",
            "fax_number": "717-733-6010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221724",
            "country_code": "US",
            "telephone_number": "717-721-4740",
            "fax_number": "717-738-6872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOZZI",
        "first_name": "MARINO",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD056528L",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD056528L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015302170001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "783382",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00269502",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.