John A. Wallace, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

MD00151900 Issued in NJ

Practice address

702 W Maple Ave
Merchantville, NJ 08109-1822

Phone

(856) 665-1180

Fax

(856) 665-5537

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Frank J Tursi D P MGroup PAC ID 4183686017, 6 clinicians

Curalta Medical LLCGroup PAC ID 0749670453, 69 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Curalta Medical LLC

  • Podiatrist
  • Park Ridge, NJ
  • NPI 1801568605

  Primary Podiatric Medicine

  Medicare reassignment Care Compare group NPD
• Frank J Tursi D P M

  • Sports Medicine Podiatrist
  • Voorhees, NJ
  • NPI 1538228960
  Medicare reassignment Care Compare group NPD
• Curalta Medical LLC

  • Durable Medical Equipment & Medical Supplies
  • Millburn, NJ
  • NPI 1679303366

  Primary Podiatric Medicine

  NPD
• Foot and Ankle Center Inc

  • Foot & Ankle Surgery Podiatrist
  • Bensalem, PA
  • NPI 1043727308

  Primary Podiatric Medicine

  NPD (past)
• Foot and Ankle Center, Inc

  • Foot & Ankle Surgery Podiatrist
  • Bensalem, PA
  • NPI 1144284605
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861426462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W MAPLE AVE",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081091822",
            "telephone_number": "856-665-1180",
            "fax_number": "856-665-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W MAPLE AVE",
            "city": "MERCHANTVILLE",
            "state": "NJ",
            "postal_code": "081091822",
            "telephone_number": "856-665-1180",
            "fax_number": "856-665-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOHN",
        "middle_name": "A.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "MD00151900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6574009",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0425672000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip A Smyth III, LPC LCADC
• Lacondia Sundiata
• Two Hearts Community Services
• Kathryn E Valenzano, NP
• Vine Community
• Wellspring Center LLC
• Christina J White, LPN
• John G Wilson, M.D.
• Your Health Now LLC

• Primary Podiatric Medicine Podiatrist in Merchantville, NJ
• Providers in Merchantville, NJ by specialty
• Primary Podiatric Medicine Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.