Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maryellen Favata

Individual provider Registered Nurse · NPI 1265195838

Maryellen Favata is a Certified Registered Nurse Anesthetist (CRNA) in Philadelphia, Pennsylvania. Qualified in 2021, 5 years ago. Practices with University of Penn-Medical Group, a 3,401-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
5
Licensed in
PA
In the registry since
2021
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Practice location Address checks out

3400 Spruce St
Philadelphia, PA 19104-4238
Phone: (215) 316-5151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence RN653863 (PA)

Record details

NPI number1265195838
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 20, 2021
Last updated in NPPESOctober 20, 2021
Certification dateOctober 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice University Of Penn-Medical Group — 3401 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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