Individual provider Active NPI

Joseph Mascaro, CRNP

  • Adult Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1841834710
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP021099 Issued in PA
Practice address
125 S 9TH St Ste 1005
Philadelphia, PA 19107-5123
Phone
(215) 543-7002
NPI assigned
Nov 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP021099 PA Primary
Gerontology Nurse Practitioner 363LG0600X SP021099 PA

Addresses

Primary practice location

125 S 9TH St Ste 1005
Philadelphia, PA 19107-5123

Mailing address

503 Natalie LN
Norristown, PA 19401-3111
Phone (570) 357-7585

Other practice location 1

125 S 9th St
Philadelphia, PA 19107-5125
Phone (215) 543-7002

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429000956 PA Practitioner - Nurse Practitioner 3173953445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Koka Cardiology PCGroup PAC ID 7517102262, 2 clinicians

Practice addresses (Care Compare)

125 S 9TH St
Sheridan BLD Suite 1005
Philadelphia, PA 19107-5125
Phone (215) 543-7002

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021099PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Koka Cardiology PC CurrentSince Jan 24, 2020 Accepting new patients
Koka Cardiology PC Past Accepting new patients

Locations

125 S 9th St
Ste 50
Philadelphia, PA 19107
Phone (215) 543-7002

125 S 9th St
Philadelphia, PA 19107
Phone (215) 592-4500

125 S 9th St
Ste 1005
Philadelphia, PA 19107
Phone (215) 543-7002

Organizations & group practices 2

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 1

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": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1841834710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 NATALIE LN",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013111",
            "telephone_number": "570-357-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 9TH ST STE 1005",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075123",
            "telephone_number": "215-543-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S 9th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075125",
            "country_code": "US",
            "telephone_number": "215-543-7002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASCARO",
        "first_name": "JOSEPH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-04",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP021099",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP021099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.