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MARIE OLIVA HENNELLY M.D.
NPI 1912393539
Family Medicine in Philadelphia, PA

Active since April 09, 2015PECOS EnrolledAccepts Medicare Assignment
401-55 W ALLEGHENY AVENUE, PHILADELPHIA, PA 19133(215) 291-2500(215) 291-2502 Get Directions Write a Review

NPPES record last updated: January 10, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 10, 2019, Jul 20, 2018 (2 updates tracked since 2018).

About Marie Oliva Hennelly M.d. NPPES

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

MARIE OLIVA HENNELLY M.D. (NPI 1912393539) is an individual family medicine provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD465402) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Christus St Vincent Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1912393539
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMARIE OLIVA HENNELLYCredential: M.D.
Location Address401-55 W ALLEGHENY AVENUEPhiladelphia, PA 19133-3644
Mailing Address1412-22 Fairmount AvenuePhiladelphia, PA 19130-2908 · (215) 684-5344 · Fax (215) 232-4093
Phone(215) 291-2500
Fax(215) 291-2502
Sole ProprietorNo
Medical School CMSIcahn School Of Medicine At Mount SinaiGraduated 2015
Enumeration DateApril 9, 2015
Last NPPES UpdateJanuary 10, 20192 updates tracked since enumeration
✔ NPI 1912393539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in PA · MD465402✔ Licensed in WA · MD60748517
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
401-55 W ALLEGHENY AVENUE, Philadelphia, PA 19133
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1550 16th Ave, Ste 100Seattle, WA 98122-5699 · Phone (206) 320-2484
Location 28720 14th Ave SSeattle, WA 98108 · Phone (206) 762-3730

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

Marie Oliva Hennelly 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 ID42526410
PECOS Enrollment IDI20260323000095
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.

Medicare Billing Reassignments

6

Medicare enrollment records show Marie Hennelly reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Meharry Health Network, PC
677 mi
Family Medicine
1648 MEMORIAL BLVD
Murfreesboro, TN 37129
  • Reassigned Medicare billing, Tennessee enrollment
  • Medicare enrollment name: Sanitas Medical Center Of Tennessee PC
  • 42 clinicians in this Medicare group
NPI 1235768458 (866) 378-5362
Collierville Pediatrics, LLC
870 mi
Pediatrics
2028 W POPLAR AVE, SUITE 112
Collierville, TN 38017
  • Reassigned Medicare billing, Tennessee enrollment
  • 5 clinicians in this Medicare group
NPI 1326229345 (901) 854-5455
The Camellia Foundation
873 mi
Family Medicine
3030 COVINGTON PIKE, SUITE 200
Memphis, TN 38128
  • Reassigned Medicare billing, Tennessee enrollment
  • 40 clinicians in this Medicare group
NPI 1609169713 (901) 432-5727
Medicos General PLLC
873 mi
Family Medicine
3030 COVINGTON PIKE, #100
Memphis, TN 38128
  • Reassigned Medicare billing, Tennessee enrollment
  • 42 clinicians in this Medicare group
NPI 1952402885 (901) 383-8889
La Familia Medical Center
1,703 mi
Federally Qualified Health Center (FQHC)
455 SAINT MICHAELS DR
Santa Fe, NM 87505
  • Reassigned Medicare billing, New Mexico enrollment
  • 33 clinicians in this Medicare group
NPI 1811059322 (505) 982-4425
Pueblo Of Jemez
1,746 mi
Clinic/Center
110 SHEEP SPRINGS WAY
Jemez Pueblo, NM 87024
  • Reassigned Medicare billing, Texas enrollment
  • 38 clinicians in this Medicare group
NPI 1417082215 (575) 834-7413

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus St Vincent Regional Medical Center

Acute Care Hospitals · Santa Fe, NM
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320002
Location455 St Michael's DriveSanta Fe, NM 87505 · Santa Fe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19133 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
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
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 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VINCENT LAMONT LPC, NCC
Counselor (Mental Health)
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
PAMELA A ALVA PORROA NP
Nurse Practitioner (Family)
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
AMULYA IYER MD
Family Medicine
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. MELANIE NICOLE CRISTOBAL DMD
Dentist
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
DR. LUCIA TOME MD
Family Medicine
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500
ARIANNA ACCAY DMD
Dentist (General Practice)
401-55 W ALLEGHENY AVENUE
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-2500

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 Hennelly's NPI number?

The NPI number for Marie Hennelly is 1912393539. It was assigned to this individual provider in the NPPES registry on April 9, 2015.

Where is Marie Hennelly located?

Marie Hennelly practices at 401-55 W Allegheny Avenue, Philadelphia, PA 19133. The listed phone number is (215) 291-2500.

What is Marie Hennelly's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Marie Hennelly enrolled in Medicare?

Yes. Marie Hennelly 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 Marie Hennelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marie Hennelly reassigns Medicare benefits to 6 organizations: Meharry Health Network, PC (Murfreesboro, TN), Collierville Pediatrics, LLC (Collierville, TN), The Camellia Foundation (Memphis, TN), Medicos General PLLC (Memphis, TN), La Familia Medical Center (Santa Fe, NM) and 1 more organization, listed in the Medicare section above. 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 Marie Hennelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Marie Hennelly affiliated with any hospitals?

According to CMS data, Marie Hennelly is affiliated with Christus St Vincent Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Marie Hennelly was last updated on January 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.