MARK ETTORE MD
NPI 1902250244
Anesthesiology - Pediatric Anesthesiology in Philadelphia, PA
About Mark Ettore Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARK ETTORE MD (NPI 1902250244) is an individual pediatric anesthesiology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT210596) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mark Ettore Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Mark Ettore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Woodbury, NJ 08096
- Reassigned Medicare billing, New Jersey enrollment
- 63 clinicians in this Medicare group
San Diego, CA 92120
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
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 Mark Ettore's NPI number?
The NPI number for Mark Ettore is 1902250244. It was assigned to this individual provider in the NPPES registry on April 22, 2016.
Where is Mark Ettore located?
Mark Ettore practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-4557.
What is Mark Ettore's specialty?
The primary specialty registered for this NPI is Anesthesiology, specializing in Pediatric Anesthesiology, with taxonomy code 207LP3000X.
Is Mark Ettore enrolled in Medicare?
Yes. Mark Ettore 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.
Which organizations bill Medicare for Mark Ettore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Ettore reassigns Medicare benefits to 2 organizations: South Jersey Anesthesia And Pain Physicians PC (Woodbury, NJ) and Southern California Permanente Medical Group (San Diego, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Ettore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Ettore was last updated on May 7, 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.
# Mark Ettore, MD · NPI 1902250244
Pediatric Anesthesiology physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since April 22, 2016.
## Identity
- **NPI:** 1902250244 (Entity type: Individual)
- **Enumerated:** April 22, 2016
- **Primary specialty:** Anesthesiology - Pediatric Anesthesiology · taxonomy 207LP3000X
- **State license:** MT210596 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3401 CIVIC CENTER BLVD, Philadelphia, PA 19104-4319
- **Phone:** (215) 590-4557
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): South Jersey Anesthesia And Pain Physicians PC (NPI 1700821352, Woodbury, NJ); Southern California Permanente Medical Group (NPI 1225060742, San Diego, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** May 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1902250244) · Data from the CMS NPPES public registry.