Joann Bevilacqua, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

SC-000653L Issued in PA

Practice address

411 E Main St
Carnegie, PA 15106-2048

Phone

(412) 279-3557

Fax

(412) 279-4357

NPI assigned

Dec 14, 2005

Last updated

Nov 19, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1558346403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E MAIN ST",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151062048",
            "telephone_number": "412-279-3557",
            "fax_number": "412-279-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E MAIN ST",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151062048",
            "telephone_number": "412-279-3557",
            "fax_number": "412-279-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC-000653L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00504099",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Britney L Bell
• Gary Betts
• Heather Betts, M.A.
• Jennifer Bialobok
• Steven Bode
• Elexis Bogden
• Laura A Boni, PHARMD.
• Cassandra Marie Bortot, M.S., CCC-SLP

• Primary Podiatric Medicine Podiatrist in Carnegie, PA
• Providers in Carnegie, PA by specialty
• Primary Podiatric Medicine Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.