Individual provider Active NPI

Jon Dominic Oliverio, DPM

  • Podiatrist
  • Norton, OH
National Provider Identifier
1710985163
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36-00-2891-0 Issued in OH
Practice address
1193 Norton Ave
Suite D
Norton, OH 44203-9516
Phone
(330) 825-7878
Fax
(330) 595-4729
NPI assigned
Jul 11, 2005
Last updated
Aug 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36-00-2891-0 OH Primary

Addresses

Primary practice location

1193 Norton Ave
Suite D
Norton, OH 44203-9516

Mailing address

1193 Norton Ave
Suite D
Norton, OH 44203-9516
Phone (330) 825-7878

Other identifiers 2

IdentifierTypeStateIssuer
0156343MedicaidOH
P01815036OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070420000374 OH Practitioner - Podiatry 0143325084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1193 Norton Ave
Suite D
Norton, OH 44203-9526
Phone (330) 825-7878

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue49
Removal of skin lesions22
Removal of nail tissue469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2891OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Institute, Inc Podiatrist Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1710985163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 NORTON AVE",
            "address_2": "SUITE D",
            "city": "NORTON",
            "state": "OH",
            "postal_code": "442039516",
            "telephone_number": "330-825-7878",
            "fax_number": "330-595-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 NORTON AVE",
            "address_2": "SUITE D",
            "city": "NORTON",
            "state": "OH",
            "postal_code": "442039516",
            "telephone_number": "330-825-7878",
            "fax_number": "330-595-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERIO",
        "first_name": "JON",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-2891-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156343",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01815036",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, OH

Sources for this page

Verify at the official NPI Registry.