NPIMap

Individual provider Active NPI

Marja Elina Mattila-Evenden, MD

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1750552089
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD434972 Issued in PA
Practice address
3535 Market Street
3Rd Floor
Philadelphia, PA 19104
Phone
(215) 746-6700
Fax
(610) 874-7241
NPI assigned
Mar 14, 2008
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD434972 PA Primary

Addresses

Primary practice location

3535 Market Street
3Rd Floor
Philadelphia, PA 19104

Mailing address

3535 Market Street
3Rd Floor.
Philadelphia, PA 19104
Phone (215) 746-6700

Other names 1

  • Marja Elina Mattila Former name

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
I20100331000140 PA Practitioner - Psychiatry 0749316610 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Jul 29, 2019 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Mar 1, 2021 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Mar 1, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. Psychiatry CurrentSince Jul 29, 2019 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Centralized Comprehensive Human Services, Inc. Current Accepting new patients
Fellowship Health Resources, Inc PastSince Dec 31, 2023 Accepting new patients
Phoenix Therapy Services, LLC Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Ste 407
Chester, PA 19013
Phone (610) 619-7413

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

320 Main St
Johnstown, PA 15901
Phone (814) 533-0123

320 Main St
Fl 2
Johnstown, PA 15901
Phone (814) 534-1095

112 N Broad St
Philadelphia, PA 19102
Phone (215) 568-0622

112 N Broad St
Rm 821
Philadelphia, PA 19102
Phone 2155680860 ext. 3364

3535 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 746-6700

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1750552089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARKET STREET",
            "address_2": "3RD FLOOR.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-746-6700",
            "fax_number": "610-497-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET STREET",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-746-6700",
            "fax_number": "610-874-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTILA-EVENDEN",
        "first_name": "MARJA",
        "middle_name": "ELINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD434972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJA",
            "last_name": "MATTILA",
            "middle_name": "ELINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.