Individual provider Active NPI

Joseph L Dimenna III, DPM

  • Podiatrist
  • Cherry Hill, NJ
National Provider Identifier
1205873155
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD02297 Issued in NJ
Practice address
496 Kings Hwy N Ste 210
Cherry Hill, NJ 08034-1015
Phone
(908) 968-9322
Fax
(856) 667-9739
NPI assigned
Jun 1, 2006
Last updated
Jan 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD02297 NJ Primary

Addresses

Primary practice location

496 Kings Hwy N Ste 210
Cherry Hill, NJ 08034-1015

Mailing address

496 Kings Hwy N Ste 210
Cherry Hill, NJ 08034-1015
Phone (908) 968-9322

Other identifiers 1

IdentifierTypeStateIssuer
6787606MedicaidNJ

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
I20050202000015 NJ Practitioner - Podiatry 2264483742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Foot and Ankle Center of South JerseyGroup PAC ID 1355392028, 2 clinicians

Practice addresses (Care Compare)

200 Bowman Dr
Suite D160
Voorhees, NJ 08043-9633
Phone (856) 247-3000

92 Brick Rd
Marlton, NJ 08053-2177
Phone (856) 985-8778

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue88
Removal of skin lesions1-10
Removal of nail tissue765
Removal or shaving of skin growth159
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD02297NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Ankle Center of South Jersey Podiatrist CurrentSince Jan 1, 2005 Accepting new patients
Family Foot and Ankle Center of South Jersey Past Accepting new patients

Locations

1020 Kings Hwy N
Ste 110
Cherry Hill, NJ 08034
Phone (856) 667-6805

496 Kings Hwy N
Ste 210
Cherry Hill, NJ 08034
Phone (856) 667-8222

92 Brick Rd
Marlton, NJ 08053
Phone (856) 988-4124

1086 Dumont Cir
Voorhees, NJ 08043
Phone (201) 484-8950

Organizations & group practices 2

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1205873155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 KINGS HWY N STE 210",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341015",
            "telephone_number": "908-968-9322",
            "fax_number": "856-667-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 KINGS HWY N STE 210",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341015",
            "telephone_number": "908-968-9322",
            "fax_number": "856-667-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMENNA III",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD02297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6787606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.