Individual provider Active NPI

Joel William Consolo, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Tiffin, OH
National Provider Identifier
1083617559
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36-00-2994-C Issued in OH
Practice address
40 Clay St
Tiffin, OH 44883-2241
Phone
(419) 443-8637
Fax
(419) 443-9937
NPI assigned
May 27, 2005
Last updated
Nov 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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 36-00-2994-C OH Primary

Addresses

Primary practice location

40 Clay St
Tiffin, OH 44883-2241

Mailing address

PO Box 177
Tiffin, OH 44883-0177
Phone (419) 443-8637

Other identifiers 3

IdentifierTypeStateIssuer
0007037229OtherOHAETNA
000000299376OtherOHANTHEM
2240695MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20031106000077 OH Practitioner - Podiatry 6406769520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

672 Miami St
Suite D
Tiffin, OH 44883-1984
Phone (419) 443-8637

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions49
Removal of nail tissue1040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Foot Inc Foot & Ankle Surgery CurrentSince Oct 1, 2003 Accepting new patients

Locations

40 Clay St
Tiffin, OH 44883
Phone (419) 443-8637

672 Miami St
Ste D
Tiffin, OH 44883
Phone (419) 443-8637

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1083617559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 177",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448830177",
            "telephone_number": "419-443-8637",
            "fax_number": "419-443-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CLAY ST",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832241",
            "telephone_number": "419-443-8637",
            "fax_number": "419-443-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSOLO",
        "first_name": "JOEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36-00-2994-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007037229",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000299376",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2240695",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.