ISSAM A MARDINI (MD) – Pain Medicine (Anesthesiology) Physician, NPI 1366439705

ISSAM A MARDINI (MD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in ANESTHESIOLOGY, INTERVENTIONAL PAIN MANAGEMENT. They hold the professional credentials MD. They hold a License No. MD060309L (PA). The NPI Number for ISSAM A MARDINI (MD) is 1366439705

Main info

Male
48 Years Of Experience
Accepts Medicare Assignment
Name
ISSAM A MARDINI (MD)
NPI
1366439705
Phone
(610) 416-4145
Address
3400 SPRUCE ST
Enumeration Date
30 September 2005
Last Update Date
27 February 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2674432040
Graduation Year
1978 (48 years ago)
PAC ID
4688623184
Group Practice PAC ID
5991617292
Professional Enrollment ID
I20050121000150
Address ID
PA190041110BA130XXBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,823 ANESTHESIOLOGY in PA

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Provider Addresses for ISSAM A MARDINI (MD)

  • Hospital of the University of Pennsylvania, 3400, Spruce Street, University City, West Philadelphia, Philadelphia, Philadelphia County, Pennsylvania, 19104, United States

    HUP-DULLES 6, ANESTHESIOLOGY DEPT

    PHILADELPHIA, PA 191044206

    Phone: (610) 416-4145

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050121000150IAnesthesiologyPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope143143$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope4140$0
00812Anesthesia for exam of colon using an endoscope3737$0
00142Anesthesia for lens surgery3231$0
00813Anesthesia for procedure on small and large bowel using an endoscope3131$0
View full utilization report →

Insurance plans in this area (ZIP 19104)

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Provider's Procedures

ISSAM A MARDINI (MD) performs procedures in ANESTHESIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYPA00142Anesthesia for lens surgery1616
ANESTHESIOLOGYPA31500Emergent insertion of breathing tube into windpipe cartilage using an endoscope2120

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991617292View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)NJ
-PA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)PA
Certified Registered Nurse Anesthetist (Crna)NY
Certified Registered Nurse Anesthetist (Crna)GA
-GA
-GA
A N E S T H E S I O L O G YPA

Reviews

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Frequently asked questions

How is ISSAM A MARDINI (MD) identified in CMS data?
CMS-hosted NPPES data lists ISSAM A MARDINI (MD) with NPI 1366439705.
Does CMS list ISSAM A MARDINI (MD) as active?
Yes — ISSAM A MARDINI (MD) is active in the NPI listing used on this page.
What healthcare role does ISSAM A MARDINI (MD) hold?
Scheduling teams often label ISSAM A MARDINI (MD) under Pain Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.
Where should I expect ISSAM A MARDINI (MD) on a map?
Expect Philadelphia, Pennsylvania as a primary anchor for ISSAM A MARDINI (MD) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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