Jordan Panicco, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO4019 Issued in FL

Practice address

425 Nursing Home Dr
Arcadia, FL 34266-3839

Phone

(863) 993-2966

NPI assigned

Jun 23, 2014

Last updated

Jan 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arcadia Medical Associates PAGroup PAC ID 6800803289, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desoto Memorial Hospital Hospital, Arcadia, FL, CCN 100175
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Arcadia Medical Associates PA

  • Internal Medicine Physician
  • Arcadia, FL
  • NPI 1891980215

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Arcadia Medical Associates PA

  dba AMA Health Providers

  • Podiatrist
  • Venice, FL
  • NPI 1649983180
  NPD

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

• Desoto County Hospital District

  dba Desoto Memorial Hospital

  • Rural Acute Care Hospital
  • Arcadia, FL
  • NPI 1528387842
  Care Compare affiliation
• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1770998478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4008",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NURSING HOME DR",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663839",
            "telephone_number": "863-993-2966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Gatehouse Rd Ste 400W",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421254",
            "country_code": "US",
            "telephone_number": "412-496-7862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANICCO",
        "first_name": "JORDAN",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "2024",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0116027378",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LICENSE",
            "identifier": "2024",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nova Path ABA LLC
• Katie M Oswald
• Gordon A Page Jr., M.D.
• Michelle Paisley
• Regina Palacios
• Chandra R Parsley, DNP, APRN
• Mahendrakumar A Patel, M.D.
• Maheshkumar Patel
• Milinda Mitul Patel, PHARMD
• Rashmi Patel, PA

• Foot & Ankle Surgery Podiatrist in Arcadia, FL
• Providers in Arcadia, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.