Individual provider Active NPI

David M Pilla, DPM

  • Foot & Ankle Surgery Podiatrist
  • Cherry Hill, NJ
National Provider Identifier
1164506176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00194900 Issued in NJ
Practice address
3020 Chapel Ave W
Cherry Hill, NJ 08002-1562
Phone
(856) 667-1856
Fax
(856) 667-1856
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 25MD00194900 NJ Primary

Addresses

Primary practice location

3020 Chapel Ave W
Cherry Hill, NJ 08002-1562

Mailing address

3020 Chapel Ave W
Cherry Hill, NJ 08002-1562
Phone (856) 667-1856

Other identifiers 1

IdentifierTypeStateIssuer
1530003MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20091023000048 NJ Practitioner - Podiatry 4385781343 Practice locations: Mount Laurel, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00194900NJMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164506176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021562",
            "telephone_number": "856-667-1856",
            "fax_number": "856-667-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021562",
            "telephone_number": "856-667-1856",
            "fax_number": "856-667-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLA",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00194900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.