Active NPI
Mark A Mazer, MD
- Pulmonary Disease Physician
- Greenville, NC
National Provider Identifier
1720083793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 200600992
- Practice address
- 521 Moye Blvd FL 1
Ecu Physicians Pulmonary/Critical Care
Greenville, NC 27834-2849 - Phone
- (252) 744-1600
- Fax
- (252) 744-1115
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD043301E | PA | |
| Pulmonary Disease Physician | 207RP1001X | 200600992 | NC | Primary |
Addresses
Primary practice location
521 Moye Blvd FL 1
Ecu Physicians Pulmonary/Critical Care
Greenville, NC 27834-2849
Mailing address
1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 534-9220
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00378420 | Other | NC | RAILROAD MEDICARE |
| 5905461 | Medicaid | NC | |
| 1420C | Other | NC | BCBS NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD043301E | PA | MD | Critical Care Medicine (Internal Medicine) Physician |
| 200600992 | NC | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Greenville, NC
- NPI 1528016938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1720083793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1086 FRANKLIN ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159054305",
"telephone_number": "814-534-9220",
"fax_number": "814-534-3290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 MOYE BLVD FL 1",
"address_2": "ECU PHYSICIANS PULMONARY/CRITICAL CARE",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342849",
"telephone_number": "252-744-1600",
"fax_number": "252-744-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZER",
"first_name": "MARK",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "PA",
"license": "MD043301E",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NC",
"license": "200600992",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00378420",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5905461",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "1420C",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.