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MIRIUM MAMMEN DO
NPI 1093563470
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since May 09, 2024PECOS Enrolled
10800 KNIGHTS RD, PHILADELPHIA, PA 19114(215) 612-5161 Get Directions Write a Review

NPPES record last updated: May 9, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mirium Mammen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRIUM MAMMEN DO (NPI 1093563470) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania, licensed in Pennsylvania (OT023449) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093563470
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMIRIUM MAMMENCredential: DO
Location Address10800 KNIGHTS RDPhiladelphia, PA 19114-4200
Mailing Address10800 Knights RdPhiladelphia, PA 19114-4200 · (215) 612-5161
Phone(215) 612-5161
Sole ProprietorNo
Enumeration DateMay 9, 2024
NPPES CertifiedMay 9, 2024
✔ NPI 1093563470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in PA · OT023449
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
10800 KNIGHTS RD, Philadelphia, PA 19114
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mirium Mammen Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANSI SHETH DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
CHERYL LYNNE GEE-MAURER CRNP
Nurse Practitioner (Primary Care)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
HEATHER MOORE RN
Nurse Anesthetist, Certified Registered
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
IAN LUMSDEN PA-C
Surgery (Trauma Surgery)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4064
PETER J GRELLA
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
DR. KRISHNA KOTHAMASU DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
GRETCHEN DAWN OVERTON DPM
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
MS. BONNIE VITTI-HUOT PA-C
Physician Assistant
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mirium Mammen's NPI number?

The NPI number for Mirium Mammen is 1093563470. It was assigned to this individual provider in the NPPES registry on May 9, 2024.

Where is Mirium Mammen located?

Mirium Mammen practices at 10800 Knights Rd, Philadelphia, PA 19114. The listed phone number is (215) 612-5161.

What is Mirium Mammen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mirium Mammen enrolled in Medicare?

Yes. Mirium Mammen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mirium Mammen was last updated on May 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.