Pennsylvania Spine to Foot Pain Specialists GP

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PENNSYLVANIA SPINE TO FOOT PAIN SPECIALISTS GP

Practice address

500 Fairmount Ave FL 1
Philadelphia, PA 19123-2890

Phone

(267) 909-9594

Fax

(267) 367-5559

NPI assigned

Apr 16, 2019

Organization subpart

No

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

Authorized official

Name

Alyssa Marie Piccillo, DPMNPI 1235513763

Title

Partner

Phone

(570) 417-4755

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alyssa Marie Piccillo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
  • NPI 1235513763
  Medicare reassignment NPD Authorized official
• Gary R Salzman, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1356397939
  NPD (past)

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1972166940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40068",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191060068",
            "telephone_number": "267-909-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FAIRMOUNT AVE FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232890",
            "telephone_number": "267-909-9594",
            "fax_number": "267-367-5559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Brown St Ste C",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191233361",
            "country_code": "US",
            "telephone_number": "267-909-9594",
            "fax_number": "267-367-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "443 Mill St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "PA",
            "postal_code": "190074801",
            "country_code": "US",
            "telephone_number": "267-909-9594",
            "fax_number": "267-367-5559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "163 N Commerce Way",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180178933",
            "country_code": "US",
            "telephone_number": "267-909-9594",
            "fax_number": "267-367-5559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENNSYLVANIA SPINE TO FOOT PAIN SPECIALISTS GP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "PICCILLO",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-417-4755",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pennsylvania Reproductive Associates
• Pennsylvania Rheumatology Associates, P.C.
• Pennsylvania School for the Deaf
• Pennsylvania Sibling Support Network Inc.
• Pennsylvania Spine & Headache Center, PC
• Pennsylvania Support Coordination, Inc
• Pennsylvania Supports Coordination Agency
• Pennsylvania Surgical Associates, P.C.
• Pennsylvania Urgent Care Centers
• Pennsylvania Vascular Associates, P.C.

• Foot & Ankle Surgery Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.