Jonathan Detommaso, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

07001204A Issued in IN

Practice address

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Phone

(260) 436-8686

Fax

(260) 436-8585

NPI assigned

Apr 11, 2012

Last updated

Nov 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

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 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedics-Indianapolis IncGroup PAC ID 7416860663, 357 clinicians

Fort Wayne Orthopaedics, LLCGroup PAC ID 7618965286, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Orthopaedic Hospital of Lutheran Health Networ Hospital, Ft Wayne, IN, CCN 150168
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Cameron Health Hospital, Angola, IN, CCN 151315

Merit-based Incentive Payment System (MIPS)

Final score

83.85 of 100Reported as group

Promoting interoperability

81

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johnathan.detommaso.p1@direct.fwortho.nextgenshare.com

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.

• Fort Wayne Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1497758429

  OH, Podiatrist

  Medicare reassignment Care Compare group NPD
• Orthopaedics-Indianapolis, Inc

  • Orthopaedic Surgery Physician
  • Indianapolis, IN
  • NPI 1336252451
  Medicare reassignment Care Compare group NPD
• Fort Wayne Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Gas City, IN
  • NPI 1699425082
  NPD
• Orthopaedics-Indianapolis, Inc

  dba Orthoindy

  • Orthopaedic Surgery Physician
  • Terre Haute, IN
  • NPI 1285433953
  NPD
• Orthopaedics-Indianapolis, Inc

  dba Orthoindy - Lafayette

  • Orthopaedic Surgery Physician
  • Lafayette, IN
  • NPI 1316210487
  NPD

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

• Cameron Memorial Community Hospital, Inc.

  • Critical Access Hospital
  • Angola, IN
  • NPI 1386683316
  Care Compare affiliation
• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Lutheran Musculoskeletal Center LLC

  dba The Orthopaedic Hospital of Lutheran Health Network

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1174706576
  Care Compare affiliation

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1033476304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468012526",
            "telephone_number": "866-401-3663",
            "fax_number": "260-407-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044133",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETOMMASO",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001204A",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001204A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201289140",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01524125",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000934131",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destiny Life Center Cog (Victory House for women)
• Kristi Detar, RBT
• Hannah Kay Detmer
• Alyssa L. Detommaso, PA-C
• Dominick Detommaso, D.P.M.
• Arthur W Detore, M.D.
• Rachael Dettling
• Jonathan Dettmer, PT
• Kristen Dettmer, PNP
• Robert Wayne Dettmer, M.D.

• Foot & Ankle Surgery Podiatrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Foot & Ankle Surgery Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.