Individual provider Active NPI

John Rafael Constantino, DPM

  • Foot & Ankle Surgery Podiatrist
  • Largo, FL
National Provider Identifier
1023577111
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4385 Issued in FL
Practice address
12416 66TH St Ste a
Largo, FL 33773-3430
Phone
(727) 547-4700
Fax
(727) 394-8661
NPI assigned
Mar 18, 2019
Last updated
Aug 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 PO4385 FL Primary

Addresses

Primary practice location

12416 66TH St Ste a
Largo, FL 33773-3430

Mailing address

12416 66TH St Ste a
Largo, FL 33773-3430
Phone (727) 547-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220622001118 FL Practitioner - Podiatry 4587043575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alexander Medical Group LLCGroup PAC ID 0547299836, 25 clinicians

Practice addresses (Care Compare)

12416 66TH St
Suite a
Largo, FL 33773-3430
Phone (727) 547-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alexander Medical Group LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

12416 66th St
Ste A
Largo, FL 33773
Phone 7275474700112

2438 Dr Ml King Jr St N
St Petersburg, FL 33704
Phone (727) 565-0740

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1023577111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12416 66TH ST STE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733430",
            "telephone_number": "727-547-4700",
            "fax_number": "727-394-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12416 66TH ST STE A",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733430",
            "telephone_number": "727-547-4700",
            "fax_number": "727-394-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINO",
        "first_name": "JOHN",
        "middle_name": "RAFAEL",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.