Individual provider Active NPI

Marc Alexander Burock, M.D.

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1831224096
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD432741 Issued in PA
Practice address
4641 Roosevelt Boulevard
Philadelphia, PA 19124-2399
Phone
(215) 831-4600
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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 MD432741 PA Primary

Addresses

Primary practice location

4641 Roosevelt Boulevard
Philadelphia, PA 19124-2399

Mailing address

4641 Roosevelt Boulevard
Philadelphia, PA 19124-2399
Phone (215) 831-4600

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
I20080716000019 PA Practitioner - Psychiatry 7416020060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Perelman School of Med at the University of Pennsylvania, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

1068 W Baltimore Pike
Media, PA 19063-5104
Phone (610) 566-9400

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

130 S Bryn Mawr Ave H
321 GVH Hospital Medical Services Bryn
Bryn Mawr, PA 19010-3121
Phone (484) 337-4097

255 W Lancaster Ave
Paoli, PA 19301-1763

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jul 29, 2009 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

414 Paoli Pike
Malvern, PA 19355
Phone (484) 596-5254

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

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.

Hospital & facility affiliations 4

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1831224096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BOULEVARD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242399",
            "telephone_number": "215-831-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BOULEVARD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242399",
            "telephone_number": "215-831-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUROCK",
        "first_name": "MARC",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD432741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.