Individual provider Active NPI

Anthony J Cordisco, DPM

  • Foot Surgery Podiatrist
  • Burlington, NJ
National Provider Identifier
1962489344
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
25MD00157400 Issued in NJ
Practice address
1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290
Phone
(609) 386-7807
Fax
(609) 386-6065
NPI assigned
Dec 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 25MD00157400 NJ Primary

Addresses

Primary practice location

1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290

Mailing address

1105 Sunset Rd
Coopertown Plaza
Burlington, NJ 08016-2290
Phone (609) 386-7807

Other identifiers 1

IdentifierTypeStateIssuer
2169703MedicaidNJ

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
I20110216000519 NJ Practitioner - Podiatry 2961615919 Practice locations: Burlington, NJ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1105 Sunset Rd
Burlington, NJ 08016-2290
Phone (609) 386-7807

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue3345
Removal or shaving of skin growth2052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00157400NJMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony J. Cordisco, DPM Foot Surgery CurrentSince Mar 19, 2002 Accepting new patients

Locations

1105 Sunset Rd
Burlngtn Twp, NJ 08016
Phone (609) 387-9242

Organizations & group practices 1

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1962489344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SUNSET RD",
            "address_2": "COOPERTOWN PLAZA",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162290",
            "telephone_number": "609-386-7807",
            "fax_number": "609-386-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SUNSET RD",
            "address_2": "COOPERTOWN PLAZA",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162290",
            "telephone_number": "609-386-7807",
            "fax_number": "609-386-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDISCO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00157400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2169703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NJ

Sources for this page

Verify at the official NPI Registry.