NPIMap

Individual provider Active NPI

Mario P Demarco, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1821291626
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD440003 Issued in PA
Practice address
51 North 39TH Street
Mutch Building, 6TH Floor
Philadelphia, PA 19104-2640
Phone
(215) 662-8777
Fax
(215) 243-3290
NPI assigned
Jun 8, 2007
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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 MD440003 PA Primary

Addresses

Primary practice location

51 North 39TH Street
Mutch Building, 6TH Floor
Philadelphia, PA 19104-2640

Mailing address

51 North 39TH Street
Mutch Building, 6TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-8777

Other identifiers 1

IdentifierTypeStateIssuer
102480032MedicaidPA

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
I20100804000209 PA Practitioner - Family Practice 7911030465 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3600 Civic Ctr Blvd
3E
Philadelphia, PA 19104-4310

3701 Market St
Philadelphia, PA 19104-5502
Phone (215) 662-2250

3737 Market St
Philadelphia, PA 19104-5545
Phone (215) 662-8777

3801 Filbert St
Penn Center for Primary Care
Philadelphia, PA 19104-2640
Phone (215) 662-9990

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince May 1, 2015 Accepting new patients
Spectrum Health Services, Inc. CurrentSince Sep 29, 2010 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Spectrum Health Services, Inc. CurrentSince Sep 29, 2010 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Spectrum Health Services Inc Past Accepting new patients

Locations

1415 N Broad St
Ste 224
Philadelphia, PA 19122
Phone (267) 275-4095

3400 Spruce St
Fl 9
Philadelphia, PA 19104
Phone (215) 662-2891

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3701 Market St
Fl 1
Philadelphia, PA 19104
Phone (215) 662-2250

5201 Haverford Ave
Philadelphia, PA 19139
Phone (215) 472-6097

Interoperability endpoints

  • Direct secure messaging: mario.demarco.1@20090.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 3

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1821291626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 NORTH 39TH STREET",
            "address_2": "MUTCH BUILDING, 6TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8777",
            "fax_number": "215-243-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 NORTH 39TH STREET",
            "address_2": "MUTCH BUILDING, 6TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-8777",
            "fax_number": "215-243-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "MARIO",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD440003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102480032",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.