Individual provider Active NPI

John Tassone Jr., DPM

  • Podiatrist
  • Glendale, AZ
National Provider Identifier
1427043165
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0466 Issued in AZ
Practice address
5620 W Thunderbird Rd
Suite G-2
Glendale, AZ 85306-4636
Phone
(602) 938-6960
Fax
(602) 938-6069
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0466 AZ Primary

Addresses

Primary practice location

5620 W Thunderbird Rd
Suite G-2
Glendale, AZ 85306-4636

Mailing address

5620 W Thunderbird Rd
Suite F-1
Glendale, AZ 85306-4636
Phone (602) 938-6960

Other identifiers 1

IdentifierTypeStateIssuer
389496MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20080708000327 AZ Practitioner - Podiatry 2365434651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0466AZMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sole Foot and Ankle Specialists PC Podiatrist Past Accepting new patients
Thunderbird Podiatry Podiatrist PastSince Oct 1, 2000 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1427043165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD",
            "address_2": "SUITE F-1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064636",
            "telephone_number": "602-938-6960",
            "fax_number": "602-938-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 W THUNDERBIRD RD",
            "address_2": "SUITE G-2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064636",
            "telephone_number": "602-938-6960",
            "fax_number": "602-938-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSONE",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389496",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.