Individual provider Active NPI

Jennifer Mary Vandemark, DPM

  • Foot & Ankle Surgery Podiatrist
  • Glen Mills, PA
National Provider Identifier
1780853804
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC005881 Issued in PA
Practice address
100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone
(610) 387-4520
Fax
(610) 387-4526
NPI assigned
Feb 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC005881 PA Primary

Addresses

Primary practice location

100 Maris Grove Way
Glen Mills, PA 19342-1282

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (610) 387-4520

Other identifiers 4

IdentifierTypeStateIssuer
3705064000OtherKEYSTONE/PERSONAL CHOICE BCBS
VA2091879OtherHIGHMARK BCBS
27-11888OtherEVERCARE
611455212001OtherTRICARE

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
I20081203000149 PA Practitioner - Podiatry 2567523004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erickson Health Medical Group of Pennsylvania PCGroup PAC ID 3870544083, 20 clinicians

Practice addresses (Care Compare)

100 Maris Grove Way
Glen Mills, PA 19342-1282
Phone (610) 387-4520

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1368
Removal or shaving of skin growth719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC005881PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Erickson Health Medical Group of Pennsylvania PC Current Accepting new patients
Erickson Health Medical Group of Pennsylvania PC CurrentSince Aug 25, 2008 Accepting new patients
Erickson Health Medical Group of Pennsylvania, PC CurrentSince Aug 25, 2008 Accepting new patients

Locations

5730 Executive Dr
Ste 230
Catonsville, MD 21228
Phone (410) 402-2379

5525 Research Park Dr
Fl 4
Catonsville, MD 21228
Phone (410) 247-5602

100 Maris Grove Way
Glen Mills, PA 19342
Phone (610) 387-4520

10000 Anns Choice Way
Warminster, PA 18974
Phone (215) 443-3801

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.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1780853804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "610-387-4520",
            "fax_number": "610-387-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIS GROVE WAY",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421282",
            "telephone_number": "610-387-4520",
            "fax_number": "610-387-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEMARK",
        "first_name": "JENNIFER",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-22",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC005881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE/PERSONAL CHOICE BCBS",
            "identifier": "3705064000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "VA2091879",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "27-11888",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "611455212001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

Verify at the official NPI Registry.