Individual provider Active NPI

Joseph C Marzzacco, DPM

  • Podiatrist
  • Carbondale, PA
National Provider Identifier
1154384386
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC-001633-L Issued in PA
Practice address
30 Lincoln Ave
Carbondale, PA 18407-1907
Phone
(570) 282-6010
NPI assigned
Apr 10, 2006
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0502755MedicaidPA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

ProcedureNumber of procedures
Removal of tissue51
Removal of skin lesions26
Removal of nail tissue315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC-001633-LPAMDPodiatrist

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

Sources for this page

Verify at the official NPI Registry.