Active NPI
Joseph C Marzzacco, DPM
- Podiatrist
- Carbondale, PA
National Provider Identifier
1154384386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC-001633-L
- Practice address
- 30 Lincoln Ave
Carbondale, PA 18407-1907 - Phone
- (570) 282-6010
- NPI assigned
- Apr 10, 2006
- Last updated
- Jul 6, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC-001633-L | PA | Primary |
Addresses
Primary practice location
30 Lincoln Ave
Carbondale, PA 18407-1907
Mailing address
30 Lincoln Ave
Carbondale, PA 18407-1907
Phone (570) 282-6010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0502755 | Medicaid | PA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110331000108 | PA | Practitioner - Podiatry | 0749463644 | Practice locations: Carbondale, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Temple University School of Podiatric Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
30 Lincoln Ave
Carbondale, PA 18407-1907
Phone (570) 282-6010
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 51 |
| Removal of skin lesions | 26 |
| Removal of nail tissue | 315 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC-001633-L | PA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1154384386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 LINCOLN AVE",
"city": "CARBONDALE",
"state": "PA",
"postal_code": "184071907",
"telephone_number": "570-282-6010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 LINCOLN AVE",
"city": "CARBONDALE",
"state": "PA",
"postal_code": "184071907",
"telephone_number": "570-282-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARZZACCO",
"first_name": "JOSEPH",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-10",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC-001633-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0502755",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carbondale, PA
- Niko Manetti, DPT
- Marian Community Hospital
- Marian Community Hospital
- Marian Community Hospital
- Dana Marie Marmo, MS CRC
- Ashley Masters
- Maxis Medical Services (maxis women's health services)
- Maxis Medical Services (pediatric care)
- Maxis Medical Services (maxis surgical services)
- Maxis Medical Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.