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PETAR MAMULA M.D.
NPI 1700895612
Pediatrics - Pediatric Gastroenterology in Philadelphia, PA

Active since August 07, 2006PECOS EnrolledAccepts Medicare Assignment
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILA - GASTRO & NUTRITION, PHILADELPHIA, PA 19104(215) 590-3247(215) 590-3606 Get Directions Write a Review

NPPES record last updated: April 15, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Petar Mamula M.d. NPPES

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

PETAR MAMULA M.D. (NPI 1700895612) is an individual pediatric gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD065396L) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1700895612
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NamePETAR MAMULACredential: M.D.
Location Address3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILA - GASTRO & NUTRITIONPhiladelphia, PA 19104-4319
Mailing Address100 E Penn Sq, 9th FloorPhiladelphia, PA 19107-3323 · (267) 425-9232 · Fax (267) 425-9299
Phone(215) 590-3247
Fax(215) 590-3606
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateAugust 7, 2006
Last NPPES UpdateApril 15, 2013
✔ NPI 1700895612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License✔ Licensed in PA · MD065396L
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Also ListedPediatricsTaxonomy 208000000X · License MD065396L (PA)
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Other Identifiers 4

Medicare UPINH40201
Medicaid8530301NJ
Medicare ID-Type Unspecified048550PA
Medicaid001847506PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Petar Mamula M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921169152
PECOS Enrollment IDI20081206000119
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Petar Mamula's NPI number?

The NPI number for Petar Mamula is 1700895612. It was assigned to this individual provider in the NPPES registry on August 7, 2006.

Where is Petar Mamula located?

Petar Mamula practices at 3401 Civic Center Blvd Children's Hospital Of Phila - Gastro & Nutrition, Philadelphia, PA 19104. The listed phone number is (215) 590-3247.

What is Petar Mamula's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Petar Mamula enrolled in Medicare?

Yes. Petar Mamula is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Petar Mamula was last updated on April 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.