DR. MARK R IZZO (NPI# 1811975584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811975584 |
| Entity Type | Individual |
| Full Name | DR. MARK R IZZO |
| Credential | MD |
| Practice Address |
2315 Myrtle St Ste 190 Erie PA 16502-4604 |
| Practice Telephone | 8144537767 |
| Practice Fax Number | 8144546667 |
| Mailing Telephone | 8144537767 |
| Mailing Fax Number | 8144546667 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD045842L | PA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD045842L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | RR MEDICARE | 060064728 | 01 |
| PA | 0071050780002 | 05 |
| Street Address |
2315 MYRTLE ST STE 190 |
| City | ERIE |
| State | PA |
| Zip Code | 16502-4604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730167487 | William L Mecca | Internal Medicine | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2006-01-04 |
| 1457996092 | Kelsey Elizabeth Cunningham | Nurse Practitioner | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2019-11-07 |
| 1225672629 | Gabrielle Marie Matarazzo | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2019-10-30 |
| 1285294470 | Emma R Scheick | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2019-06-19 |
| 1841756483 | Justine M Koehler | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2019-02-19 |
| 1831664846 | Leslee Ann Difucci | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2018-10-05 |
| 1659857043 | John Oge | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502 | 2018-07-18 |
| 1699288282 | Arijana Halilovic | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2017-11-06 |
| 1134597305 | Alyssa M Meighan | Registered Nurse | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2015-09-04 |
| 1417393927 | Susan E Bentley | Physician Assistant | 2315 Myrtle St Ste 190, Erie, PA 16502-4604 | 2013-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679064794 | Fernando Torres | Specialist/Technologist | 549 1/2 W 7th St, Erie, PA 16502 | 2018-05-24 |
| 1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
| 1730609041 | Michael Greg Palmer | Family Medicine | 311 West 24th Street 4th Floor, Erie, PA 16502 | 2017-06-27 |
| 1245658723 | Amy Adamus | Licensed Practical Nurse | 1647 Sassafras Street, Erie, PA 16502 | 2014-04-02 |
| 1295011088 | Margaret Gay Wardd | Licensed Practical Nurse | 1757 West 23 Street, Erie, PA 16502 | 2011-10-25 |
| 1659510782 | Kristen Kathleen Curry | Social Worker | 329 W. 10th St., Erie, PA 16502 | 2009-02-12 |
| 1699928416 | Kelly Cathleen Kelly-zazado | Social Worker | 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 | 2008-10-23 |
| 1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
| 1003970146 | Claire Donch | Psychologist | 301 West 10th Street, Erie, PA 16502 | 2006-12-21 |
| 1730703117 | Vincent Viet Ngo | Family Medicine | 311 West 24th Street, 4th Floor, Erie, PA 16502 | 2020-06-02 |
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| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325108 | Robert J Ferraro | Internal Medicine | 120 E. 2nd St, 2nd Floor, Erie, PA 16507-1537 | 2005-06-08 |
| 1255335220 | Gurjaipal S Kang | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1537 | 2005-06-08 |
| 1861660409 | Quentin Marc Orlando | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1537 | 2008-02-18 |
| 1861698748 | Bryan Glen Schwartz | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1537 | 2007-06-26 |
| 1417925256 | Robert L Maholic | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1579 | 2006-03-09 |
| 1902800972 | Richard W Petrella | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1537 | 2005-06-08 |
| 1972507929 | Timothy C Trageser | Internal Medicine | 120 E 2nd St Fl 2, Erie, PA 16507-1537 | 2005-06-08 |
| 1215931266 | Medicor Associates, Inc. | Internal Medicine | 120 E 2nd St, Ste 2, Erie, PA 16507-1537 | 2005-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326609686 | Grand View Hospital | Internal Medicine | 700 Lawn Ave Fl 2, Sellersville, PA 18960-1548 | 2019-06-26 |
| 1841798121 | Coordinated Health of Penn, LLC | Internal Medicine | 1700 Market St Ste 1005a104, Philadelphia, PA 19103-3913 | 2018-01-31 |
| 1124409826 | Sanjog Kalra | Internal Medicine | 5501 Old York Road, 3rd Floor Levy Building, Albert Einstein Medical Center-division of Cardiology, Philadelphia, PA 19141 | 2015-06-18 |
| 1588905095 | Harvard Cardiovascular Inc | Internal Medicine | 362 Sprague Rd, Penn Valley, PA 19072-1124 | 2013-03-07 |
| 1669784880 | Paul Lewis Hermany II | Internal Medicine | 2649 Schoenersville Rd Ste 301, Bethlehem, PA 18017 | 2010-07-02 |
| 1063651123 | Deepika Rao Kalisetti | Internal Medicine | 743 Jefferson Ave Ste 305, Scranton, PA 18510-1639 | 2009-02-13 |
| 1679591374 | Subrahmanyam Chivukula | Internal Medicine | 245 Mill Street, Bristol, PA 19007 | 2006-07-18 |
| 1710913736 | Stafford Michael Smith | Internal Medicine | 102 N Abington Rd, Suite #103, Clarks Green, PA 18411-2300 | 2006-06-23 |
| 1891732541 | Gregory D Cox | Internal Medicine | 2135 Noll Dr Ste D, Lancaster, PA 17603-7602 | 2006-06-01 |
| 1811934565 | Scott T. Riebel | Internal Medicine | 1600 6th Ave Ste 108, York, PA 17403-2626 | 2006-06-01 |
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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.