Individual provider Active NPI

Edwin Steven Damon, D.P.M.

  • Podiatrist
  • Enfield, CT
National Provider Identifier
1457464067
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000035 Issued in CT
Practice address
64 Palomba Dr
Enfield, CT 06082-3844
Phone
(860) 745-6248
Fax
(860) 741-2482
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000035 CT Primary
Podiatrist 213E00000X 1422 MA

Addresses

Primary practice location

64 Palomba Dr
Enfield, CT 06082-3844

Mailing address

64 Palomba Dr
Enfield, CT 06082-3844
Phone (860) 745-6248

Other identifiers 3

IdentifierTypeStateIssuer
4006102MedicaidCT
1019700001OtherCTNSC
0313211MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060412000643 MA Practitioner - Podiatry 9739198136 Practice locations: Chicopee, MA; Springfield, MA
I20101230000750 CT Practitioner - Podiatry 9739198136 Practice locations: Enfield, CT

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 Palomba Dr
Enfield, CT 06082-3844

64 Palomba Dr
Suite 7
Enfield, CT 06082-3850
Phone (860) 745-6248

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue2135
Removal or shaving of skin growth578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000035CTMDAddiction (Substance Use Disorder) Counselor
1422MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sone Health Medical Group, PLLC Current Accepting new patients
E. Steven Damon, D.P.M. Podiatrist CurrentSince Oct 1, 1972 Accepting new patients

Locations

64 Palomba Dr
Ste 7
Enfield, CT 06082
Phone (860) 745-6248

64 Palomba Dr
Enfield, CT 06082
Phone (860) 745-2712

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1457464067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PALOMBA DR",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823844",
            "telephone_number": "860-745-6248",
            "fax_number": "860-741-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 PALOMBA DR",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823844",
            "telephone_number": "860-745-6248",
            "fax_number": "860-741-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "EDWIN",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000035",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1422",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4006102",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "1019700001",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0313211",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.