Individual provider Active NPI

Marianne Patrcia McCormick, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1851319149
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD047603L Issued in PA
Practice address
800 Spruce St
2 Cathcart
Philadelphia, PA 19107-6130
Phone
(215) 829-3264
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD047603L PA Primary

Addresses

Primary practice location

800 Spruce St
2 Cathcart
Philadelphia, PA 19107-6130

Mailing address

800 Spruce Street
2 Cathcart
Philadelphia, PA 19107-6130
Phone (215) 829-3358

Other identifiers 1

IdentifierTypeStateIssuer
001482011MedicaidPA

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
I20120208000005 PA Practitioner - Emergency Medicine 0840457594 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047603LPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2001 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jul 1, 2001 Accepting new patients
University of Penn-Medical Group CurrentSince Jul 1, 2022 Accepting new patients

Locations

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

800 Spruce St
#2
Philadelphia, PA 19107
Phone (215) 829-3264

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1851319149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "2 CATHCART",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3358",
            "fax_number": "215-615-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "2 CATHCART",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "MARIANNE",
        "middle_name": "PATRCIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD047603L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001482011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.