Organization Active NPI

Merrimack Valley Podiatry PC

  • Foot Surgery Podiatrist
  • Dracut, MA
National Provider Identifier
1457407223
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
1904 Issued in MA
Legal business name
MERRIMACK VALLEY PODIATRY PC
Practice address
1168 Lakeview Ave
Dracut, MA 01826-4763
Phone
(978) 957-9800
Fax
(978) 957-3700
NPI assigned
Jan 26, 2007
Last updated
Mar 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Dr. John Pizzuto, DPMNPI 1831180058
Title
Podiatrist
Phone
(978) 957-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 1904 MA Primary

Addresses

Primary practice location

1168 Lakeview Ave
Dracut, MA 01826-4763

Mailing address

1168 Lakeview Ave
Dracut, MA 01826-4763
Phone (978) 957-9800

Other identifiers 4

IdentifierTypeStateIssuer
600604OtherMATUFTS HEALTH PLAN
22256OtherMAFALLON HEALTH CARE
Y77130OtherMABLUE SHIELD OF MA
9761489MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091215000615 MA Part B Supplier - Clinic/Group Practice 6204976681 Receives reassigned benefits from 3 practitioners
Practice locations: North Chelmsford, MA

National Provider Directory

National Provider Directory

Locations

1168 Lakeview Ave
Dracut, MA 01826
Phone (978) 957-9800

10 Research Pl
Ste 201
North Chelmsford, MA 01863
Phone (978) 934-0028

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1457407223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 LAKEVIEW AVE",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018264763",
            "telephone_number": "978-957-9800",
            "fax_number": "978-957-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 LAKEVIEW AVE",
            "city": "DRACUT",
            "state": "MA",
            "postal_code": "018264763",
            "telephone_number": "978-957-9800",
            "fax_number": "978-957-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK VALLEY PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "PIZZUTO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "978-957-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "600604",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON HEALTH CARE",
            "identifier": "22256",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MA",
            "identifier": "Y77130",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9761489",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dracut, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.