Individual provider Active NPI

John Gentless, DPM

  • Podiatrist
  • Voorhees, NJ
National Provider Identifier
1821031055
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
MD02135 Issued in NJ
Practice address
2301 Evesham Road
Suite 207
Voorhees, NJ 08043-4504
Phone
(185) 677-2111
Fax
(185) 677-2922
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X MD02135 NJ Primary
Sports Medicine Podiatrist 213ES0000X MD02135 NJ
Foot Surgery Podiatrist 213ES0131X MD02135 NJ

Addresses

Primary practice location

2301 Evesham Road
Suite 207
Voorhees, NJ 08043-4504

Mailing address

2301 Evesham Road
Suite 207
Voorhees, NJ 08043-4504
Phone (185) 677-2111

Other identifiers 4

IdentifierTypeStateIssuer
000046385OtherNJHIGHMARK BLUE SHIELD
01000453900OtherNJAMERICHOICE
0321123000OtherNJAMERIHEALTH
5245508MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040426000750 NJ Practitioner - Podiatry 3779579560 Practice locations: Voorhees, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2301 E Evesham Rd
Suite 207
Voorhees, NJ 08043-4504

2301 Evesham Rd
Suite 207
Voorhees, NJ 08043-4502
Phone (856) 772-1118

2301 Evesham Rd
Suite 207
Voorhees, NJ 08043-4504

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1761
Removal or shaving of skin growth154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2135NJMDClinical Psychologist
MD02135NJMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1821031055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM ROAD",
            "address_2": "SUITE 207",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434504",
            "telephone_number": "185-677-2111",
            "fax_number": "185-677-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 EVESHAM ROAD",
            "address_2": "SUITE 207",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434504",
            "telephone_number": "185-677-2111",
            "fax_number": "185-677-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTLESS",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "MD02135",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NJ",
            "license": "MD02135",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "MD02135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "000046385",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "01000453900",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0321123000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5245508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.