Organization Active NPI

William Marasovich MD Inc

  • Otolaryngic Allergy Physician
  • Sewickley, PA
National Provider Identifier
1730307471
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
MD023967L Issued in PA
Legal business name
WILLIAM MARASOVICH MD INC
Practice address
701 Broad St
Sewickley, PA 15143-1652
Phone
(412) 741-2123
Fax
(412) 741-5522
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Dr. William A Marasovich, D.D.S., M.D.NPI 1720039449
Title
President
Phone
(412) 741-2123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0602X MD023967L PA Primary

Addresses

Primary practice location

701 Broad St
Sewickley, PA 15143-1652

Mailing address

701 Broad St
Sewickley, PA 15143-1652
Phone (412) 741-2123

Other identifiers 2

IdentifierTypeStateIssuer
0014326190004MedicaidPA
761800OtherPABLUE SHIELD PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080513000244 PA Part B Supplier - Clinic/Group Practice 0749359057 Receives reassigned benefits from 1 practitioner
Practice locations: Ellwood City, PA; Sewickley, PA

National Provider Directory

National Provider Directory

Locations

701 Broad St
Ste D
Sewickley, PA 15143
Phone (412) 741-2123

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1730307471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BROAD ST",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431652",
            "telephone_number": "412-741-2123",
            "fax_number": "412-741-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BROAD ST",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431652",
            "telephone_number": "412-741-2123",
            "fax_number": "412-741-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM MARASOVICH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "MARASOVICH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-741-2123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "PA",
            "license": "MD023967L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014326190004",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "761800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.