MARK J. LIBASSI (NPI# 1215967682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215967682 |
| Entity Type | Individual |
| Full Name | MARK J. LIBASSI |
| Credential | M.D. |
| Practice Address |
3998 Red Lion Rd Suite 125 Philadelphia PA 19114-1436 |
| Mailing Address |
P. O. Box 8500 - 6335 Philadelphia PA 19178-6335 |
| Practice Telephone | 2158244559 |
| Practice Fax Number | 2156129220 |
| Mailing Telephone | 2158078000 |
| Mailing Fax Number | 2158078235 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
MD042679E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CIGNA | 0224098 | 01 |
| PA | 0014618900008 | 05 | |
| PA | AMERICHOICE | 01461890-03 | 01 |
| PA | HIGHMARK BLUE SHIELD | 431350 | 01 |
| PA | PERSONAL CHOICE | 431350 | 01 |
| PA | 0014618900005 | 05 | |
| PA | AETNA HMO | 3634221 | 01 |
| PA | TRICARE | PA0026087 | 01 |
| PA | KEYSTONE MERCY | 30017960 | 01 |
| PA | KEYSTONE IBC | 0100031000 | 01 |
| PA | 0014618900004 | 05 | |
| PA | 0014618900009 | 05 | |
| PA | HEALTH PARTNERS | 34799 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548540438 | Mark Libassi | Technician/Technologist | 1395 Atwood Ave Ste 103, Johnston, RI 02919-4930 | 2011-08-23 |
| Street Address |
3998 RED LION RD SUITE 125 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-1436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657086 | Milton E Coll | Urology | 3998 Red Lion Rd, Ste 305, Philadelphia, PA 19114-1436 | 2005-05-27 |
| 1053930974 | Methodist Associates In Healthcare, Inc | Otolaryngology | 3998 Red Lion Rd, Philadelphia, PA 19114-1445 | 2020-04-10 |
| 1720645484 | Christine Nicole Bono | Nurse Practitioner | 3998 Red Lion Rd, Philadelphia, PA 19114-1445 | 2019-05-28 |
| 1396302626 | Aria Health Physicain Services | Clinic/Center | 3998 Red Lion Rd, Philadelphia, PA 19114-1445 | 2019-05-22 |
| 1932645447 | Cajulis Pediatrics | Pediatrics | 3998 Red Lion Rd, Suite 215, Philadelphia, PA 19114-1445 | 2017-01-09 |
| 1245628486 | Aileen Rueter | Nurse Practitioner | 3998 Red Lion Rd, Suite215, Philadelphia, PA 19114-1445 | 2014-12-22 |
| 1578977989 | Marcus Allen Greco | Emergency Medicine | 3998 Red Lion Rd, Office of Academic Affairs, Philadelphia, PA 19114-1445 | 2014-06-12 |
| 1669897211 | Brian Patrick Dugan | Nurse Practitioner | 3998 Red Lion Rd, Suite 306, Philadelphia, PA 19114-1445 | 2014-02-19 |
| 1144563636 | Joseph Arcieri | Nurse Practitioner | 3998 Red Lion Rd, Suite 306, Philadelphia, PA 19114-1445 | 2013-04-03 |
| 1780926915 | Alliance Cancer Specialists,p.c. | Non-Pharmacy Dispensing Site | 3998 Red Lion Rd, Suite 130, Philadelphia, PA 19114-1445 | 2013-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629377262 | Filip Moshkovsky | Surgery | 51 N 39th St Ste 1, Philadelphia, PA 19104-2640 | 2011-03-22 |
| 1770895971 | Morgan Mcmonagle | Surgery | 3400 Spruce St, Philadelphia, PA 19104-4206 | 2010-07-06 |
| 1558497644 | Aria Health Physician Services - Trauma | Surgery | 3998 Red Lion Rd, Trauma Department, Philadelphia, PA 19114-1436 | 2007-02-26 |
| 1154478774 | Bartholomew Joseph Tortella | Surgery | Broad and Vine Streets, Philadelphia, PA 19102-1121 | 2007-01-04 |
| 1093805855 | Richard K Burns | Surgery | 230 N Broad Street, Philadelphia, PA 19102 | 2006-10-13 |
| 1881799260 | Philadelphia Health & Education Corp | Surgery | 219 N Broad St, 8th Floor, Philadelphia, PA 19107-1519 | 2006-09-13 |
| 1184642712 | Gary Welch | Surgery | 3998 Red Lion Rd, Philadelphia, PA 19114-1436 | 2006-07-18 |
| 1740219955 | Alfred R. Bogucki | Surgery | 3998 Red Lion Rd, Suite 211, Philadelphia, PA 19114-1445 | 2006-07-01 |
| 1104880970 | Alec C Beekley | Surgery | 1100 Walnut St, 5th Floor, Philadelphia, PA 19107-5563 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935635 | Taylor Logan Hall | Surgery | 702 Scott St, Philipsburg, PA 16866-2018 | 2020-05-30 |
| 1447243738 | Wyntre Brook Surgical Associates, PC | Surgery | 1399 S Queen St, Lower Level, York, PA 17403-3840 | 2005-08-23 |
| 1407455397 | Veronica Gisondi | Surgery | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2020-10-21 |
| 1497363816 | Ashley Hine | Surgery | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2020-07-22 |
| 1164047791 | Jordon Christopher Edlund | Surgery | 100 N Academy Ave, Danville, PA 17822-9800 | 2020-06-09 |
| 1922455443 | Prospect Health Access Network, Inc. | Surgery | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2016-05-16 |
| 1730508326 | Abdullah Wafa | Surgery | 1000 East Mountain Blvd, Gmg Wilkes Barre Critical Care, Wilkes Barre, PA 18711 | 2014-04-10 |
| 1669738472 | Anupamaa Seshadri | Surgery | 3550 Terrace Street, Scaife Hall Room 651, Pittsburgh, PA 15261 | 2012-04-05 |
| 1205121993 | Malia G Eischen | Surgery | 1240 S Cedar Crest Blvd Ste 308, Allentown, PA 18103-6370 | 2011-06-10 |
| 1306079272 | Quoc Thai Vu | Surgery | 1245 Highland Ave, Suite 600, Abington, PA 19001-3714 | 2009-08-26 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.