NPIMap

Individual provider Active NPI

Anna Marrissa Mazor, D.O.

  • Surgery Physician
  • Southampton, PA
National Provider Identifier
1912267386
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS018407 Issued in PA
Practice address
45 2ND Street Pike Ste 100
Southampton, PA 18966-3829
Phone
(633) 345-6215
Fax
(215) 396-3456
NPI assigned
May 20, 2012
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OT014677 PA
Surgery Physician 208600000X OS018407 PA Primary

Addresses

Primary practice location

45 2ND Street Pike Ste 100
Southampton, PA 18966-3829

Mailing address

1648 Huntingdon Pike
Medical Staff Office First Floor
Meadowbrook, PA 19046-8001
Phone (215) 938-3450

Other identifiers 1

IdentifierTypeStateIssuer
OT014677MedicaidPA

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
I20170914000082 PA Practitioner - General Surgery 8820361819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Philadelphia College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HR Physician ServicesGroup PAC ID 0042109902, 188 clinicians

Practice addresses (Care Compare)

45 2ND St Pike
Comprehensive Breast Care Surgeons
Southampton, PA 18966-3806
Phone (213) 633-3456

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy35
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT014677PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HR Physician Services Surgery CurrentSince Oct 1, 2018 Accepting new patients
HR Physician Services CurrentSince Oct 1, 2018 Accepting new patients
HR Physician Services Surgery Current Accepting new patients
HR Physician Services Past Accepting new patients
HR Physician Services PastSince Aug 25, 2019 Accepting new patients

Locations

3300 Tillman Dr
Bensalem, PA 19020
Phone (215) 244-7400

109 Central Ave
Cheltenham, PA 19012
Phone (215) 663-1500

1648 Huntingdon Pike
Fl First
Meadowbrook, PA 19046

1648 Huntingdon Pike
Ofc First
Meadowbrook, PA 19046
Phone (215) 938-3450

45 2nd Street Pike
Southampton, PA 18966
Phone (215) 633-3456

45 2nd Street Pike
Ste 100
Southampton, PA 18966
Phone (215) 633-3456

Interoperability endpoints

  • Direct secure messaging: anna.mazor.1@17399.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1337472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1912267386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 HUNTINGDON PIKE",
            "address_2": "MEDICAL STAFF OFFICE FIRST FLOOR",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190468001",
            "telephone_number": "215-938-3450",
            "fax_number": "215-938-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 2ND STREET PIKE STE 100",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663829",
            "telephone_number": "633-345-6215",
            "fax_number": "215-396-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZOR",
        "first_name": "ANNA",
        "middle_name": "MARRISSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-20",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OT014677",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "OS018407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT014677",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

Verify at the official NPI Registry.