Jerome M Privitera, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

002454 Issued in OH

Practice address

9485 Mentor Ave
Ste 200
Mentor, OH 44060-8723

Phone

(440) 205-5878

Fax

(440) 205-5875

NPI assigned

Jun 8, 2005

Last updated

Jan 21, 2008By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Enrolled in OH

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

Kent State University College of Podiatric Medicine, 1987

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGBGBA
• FHIR API: https://fhir4.healow.com/fhir/r4/BGBGBA/Endpoint/BGBGBA
• Direct secure messaging: jprivitera219635@ehrdirect.uhhospitals.org

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.

• Jerome M Privitera DPM, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Mentor, OH
  • NPI 1700969102
  Medicare reassignment NPD Authorized official
• Dr Laurence W Spivack DPM Inc

  • Podiatrist
  • Mentor, OH
  • NPI 1801380241
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1639173628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE",
            "address_2": "STE 200",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608723",
            "telephone_number": "440-205-5878",
            "fax_number": "440-205-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE",
            "address_2": "STE 200",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608723",
            "telephone_number": "440-205-5878",
            "fax_number": "440-205-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVITERA",
        "first_name": "JEROME",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "002454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000242734",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0799202",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0791214",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rebecca Ann Primiano, NP
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• Bernadette Pronty, NP-C
• Kasey Purcel

• Foot & Ankle Surgery Podiatrist in Mentor, OH
• Providers in Mentor, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; 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.