Organization Active NPI

Anthony J. Cordisco, DPM

  • Podiatrist
  • Burlington, NJ
National Provider Identifier
1144499781
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00157400 Issued in NJ
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

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Anthony J Cordisco, DPMNPI 1962489344
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)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
2169703MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930008348 NJ DME Supplier - Physician - Podiatry 1052524006 Practice locations: Burlington, NJ

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.