NPIMap

Individual provider Active NPI

Cheralyn Suzanne Perkins, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bangor, PA
National Provider Identifier
1053400804
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC-004468-L Issued in PA
Practice address
325 Blue Valley Dr
Bangor, PA 18013-1526
Phone
(610) 588-6621
Fax
(610) 588-6307
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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 SC-004468-L PA Primary

Addresses

Primary practice location

325 Blue Valley Dr
Bangor, PA 18013-1526

Mailing address

325 Blue Valley Dr
Bangor, PA 18013-1526
Phone (610) 588-6621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060327000003 PA Practitioner - Podiatry 3971511411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bangor Podiatry LLCGroup PAC ID 5496766271, 5 clinicians

Practice addresses (Care Compare)

129 N 11TH St
Bangor, PA 18013-1603
Phone (610) 588-6621

1310 Route 209
Suite 107
Gilbert, PA 18331-7751
Phone (570) 992-5779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue304
Removal of skin lesions1-10
Removal of nail tissue3751
Removal or shaving of skin growth1174
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC-004468-LPAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bangor Podiatry LLC Foot & Ankle Surgery CurrentSince Apr 15, 2006 Accepting new patients
Bangor Podiatry LLC Foot & Ankle Surgery CurrentSince Apr 15, 2006 Accepting new patients
Twin Rivers Podiatry P a Foot & Ankle Surgery PastSince Sep 1, 1997 Accepting new patients

Locations

325 Blue Valley Dr
Bangor, PA 18013
Phone (610) 588-6621

129 N 11th St
Bangor, PA 18013
Phone (610) 588-6621

224 Nazareth Pike
Unit 10
Bethlehem, PA 18020

1310 Route 209
Ste 107
Gilbert, PA 18331
Phone (570) 992-5779

Interoperability endpoints

  • Direct secure messaging: cheralyn.perkins@davidascalzodpm.chartmakerdirect.com

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.

Hospital & facility affiliations 12

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1053400804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BLUE VALLEY DR",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131526",
            "telephone_number": "610-588-6621",
            "fax_number": "610-588-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 BLUE VALLEY DR",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131526",
            "telephone_number": "610-588-6621",
            "fax_number": "610-588-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "CHERALYN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC-004468-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, PA

Sources for this page

Verify at the official NPI Registry.