Individual provider Active NPI

Chris Marukos, D.P.M.

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1689619777
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003264L Issued in PA
Practice address
8410 Bustleton Ave
Suite 3
Philadelphia, PA 19152-1924
Phone
(215) 464-3600
Fax
(215) 220-3437
NPI assigned
Jun 20, 2006
Last updated
Aug 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC003264L PA Primary

Addresses

Primary practice location

8410 Bustleton Ave
Suite 3
Philadelphia, PA 19152-1924

Mailing address

8410 Bustleton Ave
Suite 3
Philadelphia, PA 19152-1924
Phone (215) 464-3600

Other identifiers 1

IdentifierTypeStateIssuer
041134493MedicaidPA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091028000239 PA Practitioner - Podiatry 6709923519 Practice locations: Abington, PA; Dresher, PA; Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1355 Old York Rd
Suite 201
Abington, PA 19001-3413
Phone (215) 464-3600

8410 Bustleton Ave
Suite 3
Philadelphia, PA 19152-1924
Phone (215) 464-3600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions55
Removal of nail tissue19
Removal or shaving of skin growth29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003264LPAMDPodiatrist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1689619777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8410 BUSTLETON AVE",
            "address_2": "SUITE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521924",
            "telephone_number": "215-464-3600",
            "fax_number": "215-220-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8410 BUSTLETON AVE",
            "address_2": "SUITE 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521924",
            "telephone_number": "215-464-3600",
            "fax_number": "215-220-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUKOS",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003264L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041134493",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.