NPIMap

Individual provider Active NPI

Michael Macciocca, M.D.

  • Interventional Cardiology Physician
  • Wynnewood, PA
National Provider Identifier
1700012820
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD444353 Issued in PA
Practice address
100 E Lancaster Ave
Wynnewood, PA 19096
Phone
(484) 476-1000
Fax
(484) 476-9000
NPI assigned
Jun 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 25MA09075400 NJ
Interventional Cardiology Physician 207RI0011X MD444353 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
Wynnewood, PA 19096

Mailing address

100 E Lancaster Ave
Wynnewood, PA 19096-3450
Phone (484) 476-1000

Other practice location 1

222 Schanck Rd # Suie104
Freehold, NJ 07728-3068
Phone (732) 663-0300

Other practice location 2

11 Meridian Rd
Eatontown, NJ 07724-2242
Phone (732) 663-0300

Other identifiers 2

IdentifierTypeStateIssuer
343723DQUOtherNJMEDICARE
MT195033MedicaidPA

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
I20180606000724 PA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1557517869 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reading HospitalGroup PAC ID 7618886490, 179 clinicians
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians
Phoenixville Clinic Company LLCGroup PAC ID 5799796850, 135 clinicians

Practice addresses (Care Compare)

301 S 7TH Ave
Suite 2020
West Reading, PA 19611-1495
Phone (610) 375-6565

826 Main St
Suite 300
Phoenixville, PA 19460-4459
Phone (610) 983-1561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Quality
77.19
Promoting interoperability
98
Improvement activities
40
Cost
79.03

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09075400NJMDInterventional Cardiology Physician
MD444353PAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenixville Clinic Company LLC CurrentSince Apr 1, 2021 Accepting new patients
Reading Hospital CurrentSince May 1, 2024 Accepting new patients
Tower Health Medical Group CurrentSince Jul 29, 2019 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Reading Hospital CurrentSince May 1, 2024 Accepting new patients
Tower Health Medical Group CurrentSince Jul 29, 2019 Accepting new patients
Coatesville Cardiology Clinic LLC CurrentSince Sep 29, 2020 Accepting new patients
Phoenixville Clinic Company LLC Current Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Apr 1, 2021 Accepting new patients
Reading Hospital Current Accepting new patients
Reading Hospital Past Accepting new patients
Reading Professional Services Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

826 Main St
Ste 300
Phoenixville, PA 19460
Phone (610) 983-1560

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

3025 Zinn Rd
Thorndale, PA 19372
Phone (610) 384-2211

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

301 S 7th Ave
Ste 2020
West Reading, PA 19611

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1606/brand/1/csg/101/fhir/r4

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1700012820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "19096",
            "telephone_number": "484-476-1000",
            "fax_number": "484-476-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Schanck Rd # Suie104",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077283068",
            "country_code": "US",
            "telephone_number": "732-663-0300",
            "fax_number": "732-663-0301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Meridian Rd",
            "address_purpose": "LOCATION",
            "city": "Eatontown",
            "state": "NJ",
            "postal_code": "077242242",
            "country_code": "US",
            "telephone_number": "732-663-0300",
            "fax_number": "732-663-0301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACCIOCCA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-03",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NJ",
            "license": "25MA09075400",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD444353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "343723DQU",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MT195033",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.