Active NPI
Anthony J. Cordisco, DPM
- Podiatrist
- Burlington, NJ
National Provider Identifier
1144499781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 25MD00157400
- Legal business name
- ANTHONY J. CORDISCO, DPM
- Practice address
- 1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290 - Phone
- (609) 386-7807
- NPI assigned
- Feb 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anthony J Cordisco, DPM
- Title
- Owner
- Phone
- (609) 386-7807
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 25MD00157400 | NJ | Primary |
Addresses
Primary practice location
1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290
Mailing address
1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290
Phone (609) 386-7807
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2169703 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930008348 | NJ | DME Supplier - Physician - Podiatry | 1052524006 | Practice locations: Burlington, NJ |
National Provider Directory
National Provider DirectoryLocations
1105 Sunset Rd
Burlngtn Twp, NJ 08016
Phone (609) 387-9242
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot Surgery Podiatrist
- Burlington, NJ
- NPI 1962489344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205884800000",
"number": "1144499781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SUNSET RD",
"address_2": "COOPERTOWN PLAZA",
"city": "BURLINGTON",
"state": "NJ",
"postal_code": "080162290",
"telephone_number": "609-386-7807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SUNSET RD",
"address_2": "COOPERTOWN PLAZA",
"city": "BURLINGTON",
"state": "NJ",
"postal_code": "080162290",
"telephone_number": "609-386-7807"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANTHONY J. CORDISCO, DPM",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-28",
"last_updated": "2008-03-19",
"status": "A",
"authorized_official_last_name": "CORDISCO",
"authorized_official_first_name": "ANTHONY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "609-386-7807",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00157400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2169703",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.