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MARIE LIDIA CARILLO M.D.
NPI 1225416779
Pediatrics - Pediatric Cardiology in Philadelphia, PA

Active since May 15, 2015PECOS Enrolled
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 590-4040 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 19, 2024, Sep 8, 2022, Feb 22, 2016 (3 updates tracked since 2016).

About Marie Lidia Carillo M.d. NPPES

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

MARIE LIDIA CARILLO M.D. (NPI 1225416779) is an individual pediatric cardiology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD478361) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225416779
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameMARIE LIDIA CARILLOCredential: M.D.
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address1012 Laurel Oak RdVoorhees, NJ 08043-3505
Phone(215) 590-4040
Sole ProprietorYes
Enumeration DateMay 15, 2015
Last NPPES UpdateSeptember 19, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2024
✔ NPI 1225416779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
Licenses✔ Licensed in PA · MD478361✔ Licensed in NJ · 25MA11550000
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Secondary Practice Locations 2

Location 11012 Laurel Oak RdVoorhees, NJ 08043-3505 · Phone (215) 590-4040
Location 23 Cooper Plz Rm 200Camden, NJ 08103-1438 · Phone (856) 342-2001

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marie Lidia Carillo M.d. 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.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

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 Marie Carillo's NPI number?

The NPI number for Marie Carillo is 1225416779. It was assigned to this individual provider in the NPPES registry on May 15, 2015.

Where is Marie Carillo located?

Marie Carillo practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-4040.

What is Marie Carillo's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Marie Carillo enrolled in Medicare?

Yes. Marie Carillo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marie Carillo was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.