DR. JEREMY ARYEH MAZUREK MD
NPI 1336440254
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in Philadelphia, PA
Quality Rating: 79.27 out of 100 score
NPI Status: Active since November 09, 2010
Contact Information
3400 SPRUCE ST
9 GATES BLDG
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-7355
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Male
- Years of Experience 18
- Internal Medicine
- Advanced Heart Failure and Transplant Ca...
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JEREMY MAZUREK
This page provides the complete NPI Profile along with additional information for Jeremy Mazurek, an internist established in Philadelphia, Pennsylvania with a medical specialization in Internal Medicine, focusing in advanced heart failure and transplant cardiology and more than 18 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 2008. The healthcare provider is registered in the NPI registry with number 1336440254 assigned on November 2010. The practitioner's primary taxonomy code is 207RA0001X with license number MD447564 (PA). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1336440254
- Provider Name
- DR. JEREMY ARYEH MAZUREK MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3400 SPRUCE ST 9 GATES BLDG PHILADELPHIA, PA 19104
- Location Phone
- (215) 662-7355
- Mailing Address
- 3400 SPRUCE ST 9 GATES BLDG PHILADELPHIA, PA 19104
- Mailing Phone
- (215) 662-7355
- Medical School Name
- ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
- Graduation Year
- 2008
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-09-2010
- Last Update Date
- 04-30-2019
- Code Navigator
An internist like Jeremy Mazurek is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Advanced Heart Failure and Transplant Cardiology
- Taxonomy Code
- 207RA0001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD447564
- License State
- PA
- Taxonomy Description
- Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | MD447564 (PA) |
Medicare Participation & PECOS Enrollment Status
Jeremy Mazurek is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Jeremy Mazurek is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4385812338
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20110719000630
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) (HCPCS:A4221)
3 DME suppliers used 26 Medicare Claims 92 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) (HCPCS:A4222)
3 DME suppliers used 26 Medicare Claims 609 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 33 Medicare Claims 33 Services Paid
DME-Oxygen and Supplies (DC002N)
Portable oxygen concentrator, rental (HCPCS:E1392)
4 DME suppliers used 25 Medicare Claims 25 Services Paid
DME-Other DME (DE000N)
Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) (HCPCS:K0455)
3 DME suppliers used 24 Medicare Claims 24 Services Paid
DME-Other DME (DE000N)
Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)
3 DME suppliers used 24 Medicare Claims 24 Services Paid
Unknown
Treatment-Injections and Infusions (nononcologic) (RI026N)
Injection, treprostinil, 1 mg (HCPCS:J3285)
3 DME suppliers used 26 Medicare Claims 9800 Services Paid
Drugs Administered Through DME
DME-Drugs Administered Through DME (DG004N)
Treprostinil, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, 1.74 mg (HCPCS:J7686)
3 DME suppliers used 25 Medicare Claims 700 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of heart muscle
Critical care, first 30-74 minutes
Drug infusion or exercise for heart stimulation during diagnostic study
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
Follow-up hospital inpatient care per day, typically 25 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Hospital discharge day management, 30 minutes or less
Initial hospital inpatient care per day, typically 70 minutes
Insertion of tube in right heart chambers for measurement
New patient office or other outpatient visit, 60-74 minutes
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
A biopsy of the heart muscle is a procedure where a small piece of heart tissue is taken for examination. This helps doctors identify heart diseases or abnormalities. The procedure involves inserting a thin tube through a vein and into the heart, under local anesthesia.
This service was performed 23 times for 15 patientsCritical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 37 times for 14 patientsThis procedure involves administering medication or promoting physical activity to stimulate your heart. It helps doctors observe how your heart responds under stress, providing valuable insights for diagnosis and treatment planning.
This service was performed 13 times for 13 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 47 times for 35 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 147 times for 87 patientsFollow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 44 times for 31 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 293 times for 77 patientsHospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
This service was performed 16 times for 16 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 24 times for 24 patientsThis procedure involves placing a small, flexible tube into the right side of your heart. It helps assess how your heart is functioning by measuring pressures within the heart chambers. It's a key tool in diagnosing certain heart conditions.
This service was performed 33 times for 31 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 32 times for 32 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 390 times for 283 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $34.29 for a new patient copayment and $26.3 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 19104 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $137.17
- Minimum New Patient Price $59.88
- Maximum New Patient Price $180.99
- Average New Patient Copayment $34.29
- Minimum New Patient Copayment $14.97
- Maximum New Patient Copayment $45.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $105.21
- Minimum Established Patient Price $19.3
- Maximum Established Patient Price $147.29
- Average Established Patient Copayment $26.3
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $36.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 79.27, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 79.27 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 73.57
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 57.35
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 57.35
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jeremy Mazurek is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
ST FRANCIS HOSPITAL - THE HEART CENTER | 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 | (516) 562-6000 | Acute Care Hospitals | |
CHSLI ST JOSEPH HOSPITAL | 4295 HEMPSTEAD TURNPIKE BETHPAGE, NY 11714 | (516) 579-6000 | Acute Care Hospitals | |
PENN PRESBYTERIAN MEDICAL CENTER | 51 NORTH 39TH STREET PHILADELPHIA, PA 19104 | (215) 662-8000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 3 | 3 | 6 | 4 | 4 | 0 | 2 | 5 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 3 | 6 | 6 | 8 | 4 | 0 | 2 | 10 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 3 + 6 + 6 + 8 + 4 + 0 + 2 + 1 + 0 + 24 = 56 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 56 = 4 | 4 |
The NPI number 1336440254 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. HARRY BART SMELTZ DO
Anesthesiology
3400 SPRUCE ST
6 DULLES
PHILADELPHIA, PA
ZIP 19104
ISSAM A MARDINI MD
Anesthesiology
(Pain Medicine)
3400 SPRUCE ST
HUP-DULLES 6, ANESTHESIOLOGY DEPT
PHILADELPHIA, PA
ZIP 19104
BARBARA A BERNHARDT MS
Genetic Counselor, MS
3400 SPRUCE ST
535 MALONEY BLDG
PHILADELPHIA, PA
ZIP 19104
MS. JILL ELISE STOPFER MS
Genetic Counselor, MS
3400 SPRUCE ST
2007 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
MS. ROSEMARY THERESA MCMENAMIN CRNP
Nurse Practitioner
(Adult Health)
3400 SPRUCE ST
GOUND FLOOR SILVERSTEIN
PHILADELPHIA, PA
ZIP 19104
MS. LYNN GODMILOW MSW
Genetic Counselor, MS
3400 SPRUCE ST
ROOM 538 MALONEY BUILDING
PHILADELPHIA, PA
ZIP 19104
DR. JAMES DAVID KOLKER MD
Radiology
(Radiation Oncology)
3400 SPRUCE ST
PHILADELPHIA, PA
ZIP 19104
DR. RUTH HERMAN STEINMAN M.D.
Psychiatry & Neurology
(Psychiatry)
3400 SPRUCE ST
2016 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
JUDITH ANNE O' DONNELL MD
Internal Medicine
(Infectious Disease)
3400 SPRUCE ST
3 SILVERSTEIN
PHILADELPHIA, PA
ZIP 19104
UNIVERSITY OF PENN-RAD ONC
Radiology
(Radiation Oncology)
3400 SPRUCE ST
2 DONNER BUILDING
PHILADELPHIA, PA
ZIP 19104
MONICA R PAMMER PH
Physician Assistant
3400 SPRUCE ST
GROUNDS RHOADS PAVILION
PHILADELPHIA, PA
ZIP 19104
WILLIAM BAXT MD
Emergency Medicine
3400 SPRUCE ST
GROUND SILVER STE N BLDG
PHILADELPHIA, PA
ZIP 19104
CHARALAMBOS I ANDREADIS MD
Internal Medicine
(Medical Oncology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
ROLF SCHLICHTER MD
Anesthesiology
3400 SPRUCE ST
4 DULLES BUILDING
PHILADELPHIA, PA
ZIP 19104
ALISON W LOREN MD
Internal Medicine
(Hematology & Oncology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
SUSAN M DOMCHEK MD
Internal Medicine
(Medical Oncology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
CAROLYN L CAMBOR MD
Pathology
(Anatomic Pathology & Clinical Pathology)
3400 SPRUCE ST
PHILADELPHIA, PA
ZIP 19104
DU PONT GUERRY IV MD
Internal Medicine
(Hematology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
DONALD E TSAI MD
Internal Medicine
(Medical Oncology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
STEPHEN EMERSON MD
Internal Medicine
(Hematology & Oncology)
3400 SPRUCE ST
15 PENN TOWER
PHILADELPHIA, PA
ZIP 19104
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336440254, enumerated in the NPI registry as an "individual" on November 09, 2010
The provider is located at 3400 Spruce St 9 Gates Bldg Philadelphia, Pa 19104 and the phone number is (215) 662-7355
The provider's speciality is Internal Medicine with taxonomy code 207RA0001X with a focus in Advanced Heart Failure and Transplant Cardiology
The provider has more than 18 years of experience. He graduated from Albert Einstein College Of Medicine Of Yeshiva University in 2008.
Yes, as of July 06, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $137.17 with an average copayment of $34.29 for new patient appointments. Established patients should expect a typical charge of $105.21 and an average copayment of 26.3. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Biopsy of heart muscle, Critical care, first 30-74 minutes, Drug infusion or exercise for heart stimulation during diagnostic study, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Follow-up hospital inpatient care per day, typically 25 minutes, Follow-up hospital inpatient care per day, typically 35 minutes, Hospital discharge day management, 30 minutes or less, Initial hospital inpatient care per day, typically 70 minutes, Insertion of tube in right heart chambers for measurement, New patient office or other outpatient visit, 60-74 minutes and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
The practitioner is affiliated to the following hospital(s): ST FRANCIS HOSPITAL - THE HEART CENTER, CHSLI ST JOSEPH HOSPITAL and PENN PRESBYTERIAN MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on November 09, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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