Anthony C Anzalone, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC002409L Issued in PA

Practice address

2400 Maryland Rd
Ste 30
Willow Grove, PA 19090-1700

Phone

(215) 659-4400

NPI assigned

Jun 20, 2005

Last updated

Aug 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1063417640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MARYLAND RD",
            "address_2": "STE 30",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901700",
            "telephone_number": "215-659-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARYLAND RD",
            "address_2": "STE 30",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901700",
            "telephone_number": "215-659-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZALONE",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC002409L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126855902",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTOGBA-RRMEDICARE",
            "identifier": "480018099",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marina Lynn Antinozzi, AGPCNP-BC
• Robert Arnold, LSW
• Ask Pharmacy LLC (Willow Care Pharmacy)
• At Peace Wellness LLC (Affinity Well Spa)
• Atlantic Health Care PLLC
• Shahodat Azimova, PHARM.D

• Foot & Ankle Surgery Podiatrist in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.