Individual provider Active NPI

Jennifer Lynne Pappalardo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Worcester, MA
National Provider Identifier
1003141029
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0751 Issued in AZ
Practice address
123 Summer St
Department of Podiatry
Worcester, MA 01608-1216
Phone
(508) 363-7390
Fax
(508) 363-7560
NPI assigned
Oct 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0751 AZ Primary

Addresses

Primary practice location

123 Summer St
Department of Podiatry
Worcester, MA 01608-1216

Mailing address

5300 E Erickson Dr Ste 118
Suite 112
Tucson, AZ 85712-2809
Phone (520) 326-6766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120823000196 AZ Practitioner - Podiatry 6305093519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0751AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Jul 23, 2012 Accepting new patients
Banner-University Medical Group CurrentSince Jul 23, 2012 Accepting new patients
Academy Foot and Ankle Clinics LTD Foot & Ankle Surgery PastSince Dec 1, 2010 Accepting new patients

Locations

3533 Canyon de Flores
Ste C
Sierra Vista, AZ 85650
Phone (520) 458-2000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

3950 S Country Club Rd
Ste 200
Tucson, AZ 85714
Phone (520) 626-5582

3950 S Country Club Rd
Ste 140
Tucson, AZ 85714
Phone (520) 626-1609

1501 N Campbell Ave
Rm 442
Tucson, AZ 85724

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

Networks

  • NM HMO C-SNP

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373587200000",
    "number": "1003141029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 E ERICKSON DR STE 118",
            "address_2": "SUITE 112",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122809",
            "telephone_number": "520-326-6766",
            "fax_number": "520-740-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "address_2": "DEPARTMENT OF PODIATRY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-7390",
            "fax_number": "508-363-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPALARDO",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2013-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.