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DR. DOMINIC LOUIS MAZZA M.D.
NPI 1265650063
Psychiatry & Neurology - Psychosomatic Medicine in Archbald, PA

Active since April 24, 2007Opted out of Medicare · through Oct 1, 2026
398 KENNEDY DR, ARCHBALD, PA 18403(570) 876-1663(570) 876-8223 Get Directions Write a Review

NPPES record last updated: February 17, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Dominic Louis Mazza M.d. NPPES

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

DR. DOMINIC LOUIS MAZZA M.D. (NPI 1265650063) is an individual psychosomatic medicine provider in Archbald, Pennsylvania, licensed in Pennsylvania (04318E) and active in the NPI registry since April 2007. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1265650063
Entity TypeIndividualMale
Primary Taxonomy2084P0015X
Provider Legal NameDR. DOMINIC LOUIS MAZZACredential: M.D.
Location Address398 KENNEDY DRArchbald, PA 18403-1582
Mailing Address398 Kennedy DrArchbald, PA 18403-1582 · (570) 876-1663 · Fax (570) 876-8223
Phone(570) 876-1663
Fax(570) 876-8223
Sole ProprietorYes
Enumeration DateApril 24, 2007
Last NPPES UpdateFebruary 17, 2016
✔ NPI 1265650063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Psychosomatic MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084P0015X
License✔ Licensed in PA · 04318E
Definition
Psychosomatic Medicine is subspecialty in the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. This subspecialty includes treatment of patients with acute or chronic medical, neurological, obstetrical or surgical illness in which psychiatric illness is affecting their medical care and/or quality of life such as HIV infection, organ transplantation, heart disease, renal failure, cancer, stroke, traumatic brain injury, high-risk pregnancy and COPD, among others. Patients also may be those who have a psychiatric disorder that is the direct consequence of a primary medical condition, or a somatoform disorder or psychological factors affecting a general medical condition. Psychiatrists specializing in Psychosomatic Medicine provide consultation-liaison services in general medical hospitals, attend on medical psychiatry inpatient units, and provide collaborative care in primary care and other outpatient settings.
398 KENNEDY DR, Archbald, PA 18403
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Other Identifiers 1

Medicare UPINC89090PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Dominic Louis Mazza M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Dominic Mazza's NPI number?

The NPI number for Dominic Mazza is 1265650063. It was assigned to this individual provider in the NPPES registry on April 24, 2007.

Where is Dominic Mazza located?

Dominic Mazza practices at 398 Kennedy Dr, Archbald, PA 18403. The listed phone number is (570) 876-1663.

What is Dominic Mazza's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychosomatic Medicine, with taxonomy code 2084P0015X.

Is Dominic Mazza enrolled in Medicare?

No. Dominic Mazza has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Dominic Mazza was last updated on February 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.