Individual provider Active NPI

Jack Daly, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Malden, MA
National Provider Identifier
1063505360
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
2149 Issued in MA
Practice address
253 Salem St
Malden, MA 02148-4118
Phone
(781) 322-7716
Fax
(781) 322-7727
NPI assigned
Oct 2, 2006
Last updated
Aug 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 2149 MA Primary
Foot Surgery Podiatrist 213ES0131X 2149 MA

Addresses

Primary practice location

253 Salem St
Malden, MA 02148-4118

Mailing address

PO Box 190
Malden, MA 02148-0002
Phone (781) 322-7716

Other identifiers 1

IdentifierTypeStateIssuer
0326534MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060406000429 MA Practitioner - Podiatry 9133138993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daly Foot Care, PCGroup PAC ID 1557406345, 2 clinicians

Practice addresses (Care Compare)

253 Salem St
Malden, MA 02148-4118
Phone (781) 322-7716

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue6789
Removal or shaving of skin growth4228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2149MAMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daly Foot Care, PC Primary Podiatric Medicine CurrentSince Sep 11, 2000 Accepting new patients

Locations

1030 President Ave
Ste 116
Fall River, MA 02720
Phone (508) 235-6204

253 Salem St
Malden, MA 02148
Phone (781) 322-7716

541 High St
Westwood, MA 02090
Phone (781) 326-7700

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1063505360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021480002",
            "telephone_number": "781-322-7716",
            "fax_number": "781-322-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484118",
            "telephone_number": "781-322-7716",
            "fax_number": "781-322-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MA",
            "license": "2149",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "2149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326534",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.