Active NPI
Nicholas John Perfetti
- Foot & Ankle Surgery Podiatrist
- Philadelphia, PA
National Provider Identifier
1417519125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- SC007027
- Practice address
- 3900 Woodland Ave
Philadelphia, PA 19104-4551 - Phone
- (215) 208-7966
- NPI assigned
- Jul 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | SC007027 | PA | Primary |
Addresses
Primary practice location
3900 Woodland Ave
Philadelphia, PA 19104-4551
Mailing address
3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone (215) 208-7966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gordon Podiatry, LLC | Single Specialty | Current | Accepting new patients |
Locations
2285 Cross Rd
Glenside, PA 19038
Phone (215) 887-2001
Interoperability endpoints
- nicholas.perfetti.1@23630.direct.athenahealth.com
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": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1417519125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044551",
"telephone_number": "215-208-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044551",
"telephone_number": "215-208-7966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERFETTI",
"first_name": "NICHOLAS",
"middle_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-02",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "PA",
"license": "SC007027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.