Individual provider Active NPI

Christine M. Mazzola, FNP-BC

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1669471314
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000288 Issued in DE
Practice address
86 Omega Dr Ste 86
Newark, DE 19713-2065
Phone
(302) 738-5500
Fax
(302) 738-9449
NPI assigned
Jul 15, 2005
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0000288 DE Primary

Addresses

Primary practice location

86 Omega Dr Ste 86
Newark, DE 19713-2065

Mailing address

405 Silverside Rd Ste 111
Wilmington, DE 19809-1768
Phone (302) 798-0666

Other practice location 1

2600 Glasgow Ave Ste 124
Newark, DE 19702-4777
Phone (302) 836-4200

Other practice location 2

405 Silverside Rd Ste 111
Wilmington, DE 19809-1768
Phone (302) 798-0666

Other identifiers 1

IdentifierTypeStateIssuer
0001172542MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110001019 DE Practitioner - Nurse Practitioner 2163617614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Total Care Physicians, P.a.Group PAC ID 6901870948, 10 clinicians

Practice addresses (Care Compare)

Omega Dr B
Newark, DE 19713
Phone (302) 738-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0000288DEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Physicians, P.a. CurrentSince Jan 2, 2001 Accepting new patients
Koniver Fiss Mansoory MD PA Past Accepting new patients

Locations

2600 Glasgow Ave
Ste 124
Newark, DE 19702
Phone (302) 332-3312

86 Omega Dr
Ste 86
Newark, DE 19713
Phone (302) 738-5500

86B Omega Dr
Bldg B
Newark, DE 19713

1320 Philadelphia Pike
Wilmington, DE 19809
Phone (302) 798-0666

405 Silverside Rd
Ste 111
Wilmington, DE 19809
Phone (302) 798-0666

Interoperability endpoints

  • Direct secure messaging: christine.mazzola.1@28224.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/28224/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1669471314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 SILVERSIDE RD STE 111",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091768",
            "telephone_number": "302-798-0666",
            "fax_number": "302-798-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 OMEGA DR STE 86",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132065",
            "telephone_number": "302-738-5500",
            "fax_number": "302-738-9449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Glasgow Ave Ste 124",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197024777",
            "country_code": "US",
            "telephone_number": "302-836-4200",
            "fax_number": "302-836-8431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Silverside Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198091768",
            "country_code": "US",
            "telephone_number": "302-798-0666",
            "fax_number": "302-798-2401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "CHRISTINE",
        "middle_name": "M.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001172542",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.