Demetrios Menegos, D.O.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

OS014890 Issued in PA

Practice address

3039 Foulk Rd
Garnet Valley, PA 19060-1701

Phone

(610) 361-0070

Fax

(610) 361-0071

NPI assigned

Nov 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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

• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD
• Oncall Physician Staffing, Inc

  • Hospitalist Physician
  • Elizabeth, NJ
  • NPI 1255608980
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1669653812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "SUITE 256 LANKENAU MOB EAST",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-649-8055",
            "fax_number": "610-649-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3039 FOULK RD",
            "city": "GARNET VALLEY",
            "state": "PA",
            "postal_code": "190601701",
            "telephone_number": "610-361-0070",
            "fax_number": "610-361-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENEGOS",
        "first_name": "DEMETRIOS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS014890",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose M. Likeness, PSY.D.
• Gene P Maraldo, RPH
• Paris Trent Massey
• Matson Performance Group (Mid-Atlantic Physical Therapy)
• Kevin P McKelvey, CRNA
• Jhoel Mercado, PT
• Moby Ventures LLC
• Jennifer Moore
• Marisa Morelli, M.S.
• Motherly Home Health Care, LLC.

• Sports Medicine (Family Medicine) Physician in Garnet Valley, PA
• Providers in Garnet Valley, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.