Active NPI
Mark Anthony Bellezza, D. P.M.
- Podiatrist
- Easton, PA
National Provider Identifier
1609027358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC002550L
- Practice address
- 6 Charles CT
Easton, PA 18045-2150 - Phone
- (610) 258-1595
- NPI assigned
- Sep 30, 2008
- Last updated
- Sep 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC002550L | PA | Primary |
Addresses
Primary practice location
6 Charles CT
Easton, PA 18045-2150
Mailing address
12604 Gould Rd
Silver Spring, MD 20906-3824
Phone (301) 785-9675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC002550L | PA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222732800000",
"number": "1609027358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12604 GOULD RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209063824",
"telephone_number": "301-785-9675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CHARLES CT",
"city": "EASTON",
"state": "PA",
"postal_code": "180452150",
"telephone_number": "610-258-1595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLEZZA",
"first_name": "MARK",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D. P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-30",
"last_updated": "2008-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC002550L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Easton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.