Active NPI
Paul R Quintavalle Jr., DPM
- Foot & Ankle Surgery Podiatrist
- Cherry Hill, NJ
National Provider Identifier
1740219161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- MD001056
- Practice address
- 69 Haddonfield Berlin Rd Ste 1
Cherry Hill, NJ 08034-3572 - Phone
- (856) 858-0180
- Fax
- (858) 869-3080
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | MD001056 | NJ | Primary |
Addresses
Primary practice location
69 Haddonfield Berlin Rd Ste 1
Cherry Hill, NJ 08034-3572
Mailing address
69 Haddonfield Berlin Rd Ste 1
Cherry Hill, NJ 08034-3572
Phone (856) 858-0180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1735501 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD001056 | NJ | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Medical Group, PA | Foot & Ankle Surgery | Past | Accepting new patients |
| Paul R. Quintavalle | Foot & Ankle Surgery | Past | Accepting new patients |
| Dr Richard H Rowe and Paul R Quintavalle | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Podiatrist
- Collingswood, NY
- NPI 1407981533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540425600000",
"number": "1740219161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 HADDONFIELD BERLIN RD STE 1",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080343572",
"telephone_number": "856-858-0180",
"fax_number": "858-869-3080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 HADDONFIELD BERLIN RD STE 1",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080343572",
"telephone_number": "856-858-0180",
"fax_number": "858-869-3080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINTAVALLE",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2018-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NJ",
"license": "MD001056",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1735501",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.