Individual provider Active NPI

Angelo B Sutera Jr., DPM

  • Podiatrist
  • Media, PA
National Provider Identifier
1295722874
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003658L Issued in PA
Practice address
280 N Providence Rd Ste 103
Media, PA 19063-3530
Phone
(610) 566-4563
Fax
(610) 566-1856
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X SC003658L PA
Podiatrist 213E00000X SC003658L PA Primary

Addresses

Primary practice location

280 N Providence Rd Ste 103
Media, PA 19063-3530

Mailing address

280 N Providence Rd Ste 103
Media, PA 19063-3530
Phone (610) 566-4563

Other identifiers 1

IdentifierTypeStateIssuer
1445475MedicaidPA

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
I20060330000049 PA Practitioner - Podiatry 6507874880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Foot and Ankle Centers PLLCGroup PAC ID 8527399591, 29 clinicians

Practice addresses (Care Compare)

280 N Providence Rd
Sutera and Jones Surgical Podiatry
Media, PA 19063-3527
Phone (610) 642-5040

Hospital & facility affiliations

  • Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
  • Residential Home Health of Carlisle LLC Home health agency, Havertown, PA, CCN 397645
  • Bayada Home Health Care, Inc. Home health agency, Newtown Square, PA, CCN 398267
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

Merit-based Incentive Payment System (MIPS)

Final score
84.79 of 100Reported as group
Quality
72.83
Promoting interoperability
98
Improvement activities
40
Cost
72.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue557
Removal of skin lesions1-10
Removal of nail tissue5447
Removal or shaving of skin growth2437
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003658LPAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Foot and Ankle Centers PLLC Podiatrist CurrentSince Jul 10, 2019 Accepting new patients
Pace Foot and Ankle Centers PLLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

599 Arcola Rd
Collegeville, PA 19426
Phone (484) 565-8440

500 Evergreen Dr
Ste G5
Glen Mills, PA 19342
Phone (610) 566-4383

1020 Baltimore Pike
Ste 220
Glen Mills, PA 19342
Phone (610) 361-8300

1068 W Baltimore Pike
Ste 3415
Media, PA 19063
Phone (484) 444-2243

280 N Providence Rd
Media, PA 19063
Phone (610) 565-6843

280 N Providence Rd
Ste 103
Media, PA 19063
Phone (610) 566-4563

Interoperability endpoints

  • Direct secure messaging: asutera@pace.emadirect.md
  • Direct secure messaging: sutera.angelo.010.0380115@snjsp.meditab.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1295722874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 N PROVIDENCE RD STE 103",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633530",
            "telephone_number": "610-566-4563",
            "fax_number": "610-566-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N PROVIDENCE RD STE 103",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633530",
            "telephone_number": "610-566-4563",
            "fax_number": "610-566-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTERA",
        "first_name": "ANGELO",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC003658L",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003658L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1445475",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.