Individual provider Active NPI

Maria Disalvo-Tuckman, MD

  • Pediatrics Physician
  • West Reading, PA
National Provider Identifier
1831182302
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD050290L Issued in PA
Practice address
301 S 7TH Ave
Suite 3170
West Reading, PA 19611-1410
Phone
(610) 898-9380
Fax
(610) 478-1170
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD050290L PA Primary

Addresses

Primary practice location

301 S 7TH Ave
Suite 3170
West Reading, PA 19611-1410

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other identifiers 1

IdentifierTypeStateIssuer
001464416MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090811000701 PA Practitioner - Pediatric Medicine 4587718473 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince May 1, 2015 Accepting new patients
Tower Health Medical Group CurrentSince May 1, 2015 Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

301 S 7th Ave
Ste 3170
West Reading, PA 19611
Phone (610) 374-4491

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

950B N Wyomissing Blvd
Wyomissing, PA 19610
Phone (610) 898-1820

2101 State Hill Rd
Ste 6
Wyomissing, PA 19610
Phone (610) 898-9380

Interoperability endpoints

  • Direct secure messaging: mdisalvotuckman2479@direct.readinghealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1831182302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 7TH AVE",
            "address_2": "SUITE 3170",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111410",
            "telephone_number": "610-898-9380",
            "fax_number": "610-478-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISALVO-TUCKMAN",
        "first_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD050290L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001464416",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.