Individual provider Active NPI

John H. Geovjian, D.P.M.

  • Podiatrist
  • Glenolden, PA
National Provider Identifier
1285664516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003101-L Issued in PA
Practice address
600 Magnolia Ave
Glenolden, PA 19036-1004
Phone
(610) 622-2818
Fax
(610) 622-2360
NPI assigned
Jul 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Podiatrist 213E00000X SC003101-L PA Primary

Addresses

Primary practice location

600 Magnolia Ave
Glenolden, PA 19036-1004

Mailing address

600 Magnolia Ave
Glenolden, PA 19036-1004
Phone (610) 622-2818

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
I20111208000387 PA Practitioner - Podiatry 4284809914 Practice locations: Glenolden, PA; Prospect Park, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Magnolia Ave
Glenolden, PA 19036-1004
Phone (610) 622-2818

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003101-LPAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285664516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAGNOLIA AVE",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361004",
            "telephone_number": "610-622-2818",
            "fax_number": "610-622-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAGNOLIA AVE",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361004",
            "telephone_number": "610-622-2818",
            "fax_number": "610-622-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEOVJIAN",
        "first_name": "JOHN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003101-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenolden, PA

Sources for this page

Verify at the official NPI Registry.