Individual provider Active NPI

Maria Mazzotti, DO

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1689601288
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS008840L Issued in PA
Practice address
601 Walnut St
Suite 230E
Philadelphia, PA 19106-3323
Phone
(215) 334-4049
Fax
(215) 462-9722
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS008840L PA Primary

Addresses

Primary practice location

601 Walnut St
Suite 230E
Philadelphia, PA 19106-3323

Mailing address

3960 Lankenau Ave
Philadelphia, PA 19131-2827
Phone (215) 829-0101

Other identifiers 1

IdentifierTypeStateIssuer
01651876MedicaidPA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071112000520 PA Practitioner - Family Practice 7719075506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rittenhouse Internal Medicine, PCGroup PAC ID 8820173081, 13 clinicians

Practice addresses (Care Compare)

1632 Pine St
Philadelphia, PA 19103-6711
Phone (215) 670-5843

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS008840LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rittenhouse Internal Medicine, PC CurrentSince Jan 26, 2013 Accepting new patients
South Philadelphia Family Medicine Family Medicine Past Accepting new patients
Penn Medicine CCP Past Accepting new patients

Locations

1632 Pine St
Philadelphia, PA 19103
Phone (215) 670-5843

Interoperability endpoints

  • Direct secure messaging: maria.mazzotti@rim.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1689601288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 LANKENAU AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312827",
            "telephone_number": "215-829-0101",
            "fax_number": "215-829-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALNUT ST",
            "address_2": "SUITE 230E",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063323",
            "telephone_number": "215-334-4049",
            "fax_number": "215-462-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOTTI",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008840L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01651876",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.