Individual provider Active NPI

Mark Anthony Lombardo, DPM

Podiatrist
Ocoee, FL

National Provider Identifier

1942386164

Registry record updated Jul 25, 2012

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Ocoee, FL
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: PodiatristTaxonomy code 213E00000X
License: P02266 Issued in FL
Practice address: 1151 Blackwood Avenue
Suite 120
Ocoee, FL 34761-4519
Phone: (407) 578-9922
Fax: (407) 578-9944
NPI assigned: Oct 31, 2006
Last updated: Jul 25, 2012By the provider in NPPES
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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
Podiatrist	213E00000X	P02266	FL	Primary

Addresses

Primary practice location

1151 Blackwood Avenue
Suite 120
Ocoee, FL 34761-4519

Mailing address

1151 Blackwood Avenue
Suite 120
Ocoee, FL 34761-4519
Phone (407) 578-9922

Other identifiers 23

Identifier	Type	State	Issuer
9737791	Other		GHI
206983	Other		AMERIGROUP
21763	Other		HUMANA CHOICE CARE
390114900	Medicaid	FL
115560	Other		BCBS VIRTUAL OFFICE
257432	Other		COVENTRY
65291	Other		BCBS
8990527	Other		INDEP HEALTH ASSOC
9653866	Other		GHI
P2637219	Other		OXFORD
10178101	Other		CITRUS CARE
185216321768	Other		HUMANA EPO
4472107	Other		AETNA PPO
001341964	Other		HIGHMARK
467623	Other		CIGNA
480034764	Other		PALMETTO
65291B	Other		MEDICARE
660814	Other		CIGNA
P122459	Other		PREFERRED ADMIN
002054967	Other		APWU
2812186	Other		AETNA HMO
441365	Other		AMERIHEALTH
593642019	Other		OUR TAX ID

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Enrolled

State licenses

License	State	Type	Specialty
P02266	FL	MD	Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1942386164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 BLACKWOOD AVENUE",
            "address_2": "SUITE 120",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614519",
            "telephone_number": "407-578-9922",
            "fax_number": "407-578-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 BLACKWOOD AVENUE",
            "address_2": "SUITE 120",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614519",
            "telephone_number": "407-578-9922",
            "fax_number": "407-578-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P02266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9737791",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "206983",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA CHOICE CARE",
            "identifier": "21763",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390114900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS VIRTUAL OFFICE",
            "identifier": "115560",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "257432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65291",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEP HEALTH ASSOC",
            "identifier": "8990527",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9653866",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2637219",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS CARE",
            "identifier": "10178101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA EPO",
            "identifier": "185216321768",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4472107",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001341964",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "467623",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "480034764",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "65291B",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "660814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ADMIN",
            "identifier": "P122459",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APWU",
            "identifier": "002054967",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2812186",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "441365",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUR TAX ID",
            "identifier": "593642019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.