Individual provider Active NPI

John A Pron, DPM

  • Foot & Ankle Surgery Podiatrist
  • Media, PA
National Provider Identifier
1063414373
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC002200L Issued in PA
Practice address
1118 W Baltimore Pike Ste 100
Media, PA 19063-6105
Phone
(484) 227-8370
Fax
(484) 227-1645
NPI assigned
Jun 1, 2005
Last updated
Jan 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 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 SC002200L PA Primary

Addresses

Primary practice location

1118 W Baltimore Pike Ste 100
Media, PA 19063-6105

Mailing address

118 Powderhorn LN
Media, PA 19063-4520
Phone (484) 442-8066

Other identifiers 1

IdentifierTypeStateIssuer
001018171MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100721000431 PA Practitioner - PodiatryPractitioner - Other (Physician) 7517099930 Practice locations: Media, PA; Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6241 Frankford Ave
Philadelphia, PA 19135-3404
Phone (215) 335-2010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue331
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC002200LPAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Apr 1, 2021 Accepting new patients

Locations

1088 W Baltimore Pike
Ste 2110
Media, PA 19063
Phone (610) 565-6226

1118 W Baltimore Pike
Ste 100
Media, PA 19063
Phone (484) 227-8350

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 2

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1063414373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 POWDERHORN LN",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634520",
            "telephone_number": "484-442-8066",
            "fax_number": "484-442-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W BALTIMORE PIKE STE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190636105",
            "telephone_number": "484-227-8370",
            "fax_number": "484-227-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRON",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002200L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001018171",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.