Nicholas Gerard Pellicoro, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00177800 Issued in NJ

Practice address

530 Franklin Avenue
Nutley, NJ 07110-1720

Phone

(973) 667-1066

Fax

(732) 752-8054

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1508922410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101720",
            "telephone_number": "973-667-1066",
            "fax_number": "732-752-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 FRANKLIN AVENUE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101720",
            "telephone_number": "973-667-1066",
            "fax_number": "732-752-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICORO",
        "first_name": "NICHOLAS",
        "middle_name": "GERARD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00177800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166470101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Dell'Aquila, M.D., P.C.
• Camille V. Pazienza, LCSW, MA
• Jill Garripoli Pedalino, D.O.
• Linda Christina Peeters
• Cleotilde C. Pelgone, PHYSICAL THERAPIST
• Jessica Peralta, M.S. CCC-SLP
• Kenia Peralta, CCC-SLP
• Gregory Carl Perez, D.M.D.
• Jennifer Perez, LPC
• Periollp

• Podiatrist in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.