Jason Gannon, D.P.M.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

25MD00257500 Issued in NJ

Practice address

111 Mulberry St
Suite 1R
Newark, NJ 07102-4008

Phone

(973) 818-9104

NPI assigned

Jul 12, 2006

Sex

Male

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

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Kenneth Frank

  • Foot & Ankle Surgery Podiatrist
  • Newark, NJ
  • NPI 1942421839
  NPD (past)
• Happy Days Adult Day Healthcare Center

  • Adult Day Care Clinic/Center
  • East Orange, NJ
  • NPI 1306051941
  NPD (past)
• Happy Days III Adult Healthcare

  • Adult Day Care Clinic/Center
  • Jersey City, NJ
  • NPI 1568677144
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1619992690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SAFRAN AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373205",
            "telephone_number": "973-818-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MULBERRY ST",
            "address_2": "SUITE 1R",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024008",
            "telephone_number": "973-818-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "JASON",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00257500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8238502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dinesh Ganatra
• Heenal Gandhi, PA
• Nayan Manish Gandhi, MD
• Vijaya Lakshmi Ganesh, M.D.
• Maureen Gang, M.D.
• Robyn Kia Gantt, M.D.
• Qianhui Gao
• Luis Garay, MD
• Arnold Garbut, RPH
• Stephanie C Garces

• Foot Surgery Podiatrist in Newark, NJ
• Providers in Newark, NJ by specialty
• Foot Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.