Individual provider Active NPI

William Thomas Defeo, DPM

  • Podiatrist
  • Allentown, PA
National Provider Identifier
1164520524
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC001701L Issued in PA
Practice address
3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4812
Phone
(610) 821-0444
Fax
(610) 820-7006
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC001701L PA Primary

Addresses

Primary practice location

3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4812

Mailing address

3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4812
Phone (610) 821-0444

Other identifiers 3

IdentifierTypeStateIssuer
02345900OtherPACAPITAL BLUE CROSS
01188301OtherPACAPITOL BLUE CROSS
0041080000OtherPAINDEPENDENCE BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091230000194 PA Practitioner - Podiatry 9032259825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Defeo and Lilly, PC Podiatrist CurrentSince Aug 1, 1977 Accepting new patients

Locations

3131 College Heights Blvd
Ste 1500
Allentown, PA 18104
Phone (610) 821-0444

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1164520524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1500",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044812",
            "telephone_number": "610-821-0444",
            "fax_number": "610-820-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1500",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044812",
            "telephone_number": "610-821-0444",
            "fax_number": "610-820-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFEO",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001701L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02345900",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITOL BLUE CROSS",
            "identifier": "01188301",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0041080000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.