Theodros Mariam, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA053056 Issued in PA

Practice address

1033 W Germantown Pike
Valley Forge Medical Center & Hospital
Norristown, PA 19403-3905

Phone

(610) 539-8500

NPI assigned

Mar 9, 2008

Last updated

Feb 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avenues Recovery Medical Center at Valley ForgeGroup PAC ID 3678972130, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Forge Medical Center Hospital, Norristown, PA, CCN 390272

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Avenues Recovery Medical Center at Valley Forge

  • Addiction Medicine (Family Medicine) Physician
  • Norristown, PA
  • NPI 1326622069
  Medicare reassignment Care Compare group NPD
• Grand View Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Sellersville, PA
  • NPI 1891359287
  Medicare reassignment
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke's Physicians Group Inc.

  dba St. Luke's Harleysville Pediatrics

  • Pediatrics Physician
  • Harleysville, PA
  • NPI 1386211290
  NPD

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

• Avenues Recovery Medical Center at Valley Forge

  dba Valley Forge Medical Center

  • General Acute Care Hospital
  • Norristown, PA
  • NPI 1407430291
  Care Compare affiliation

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

{
    "created_epoch": "1205020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1679743330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 COMMUNITY DR",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194466212",
            "telephone_number": "215-855-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 W GERMANTOWN PIKE",
            "address_2": "VALLEY FORGE MEDICAL CENTER & HOSPITAL",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194033905",
            "telephone_number": "610-539-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIAM",
        "first_name": "THEODROS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-09",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maral I Seroon LLC (JOY dental)
• Marc a Karpo Podiatry LLC
• George Joseph Marcucci I, PTA
• Frank A Margiotti, DC
• Nora Marta Margolis, M.D.
• Markley Operator, LLC (Markley Rehabilitation and Healthcare Center)
• Marshall Dental Associates LLC (Smile Concepts)
• Ada Bertha Martin, PHARM D
• Joshua S Martin, D.O.
• Danielle Angelica Martorella, RN

• Medical Physician Assistant in Norristown, PA
• Providers in Norristown, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.