MARIO NATALE PONTICELLO


Address: 9040 Jackson Ave, Tacoma, WA 98431-0001
Phone: 2539683505

MARIO NATALE PONTICELLO (NPI# 1134395734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134395734
Entity Type Individual
Full Name MARIO NATALE PONTICELLO
Credential DPM
Practice Address 9040 Jackson Ave
Tacoma
WA 98431-0001
Practice Telephone 2539683505
Mailing Telephone 2539683505
Enumeration Date 2008-05-03
Last Update Date 2020-01-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
950-25 WI Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI RAIL ROAD MEDICARE P00695367 01
WI 43244600 05

Office Location

Street Address 9040 JACKSON AVE
City TACOMA
State WA
Zip Code 98431-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356345185 John E Buonora Nurse Anesthetist, Certified Registered 9040 Jackson Ave, Tacoma, WA 98431-2025 2005-06-09
1629675251 Brian Rankin Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-10-06
1508473869 Allyssa Lynn Borak Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-09-30
1093322299 Jessica Granger Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-09-30
1134736481 Rebecca Reinhardt Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-09-29
1184238479 Mark Nash Physical Therapist 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-09-03
1679191969 Christopher A Land Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-07-13
1396362604 Valerie Kruger Genetic Counselor, MS 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-07-02
1255958724 Michael Wong Student in an Organized Health Care Education/Training Program 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-07-01
1841813391 Kailey Utley Optometrist 9040 Jackson Ave, Tacoma, WA 98431-0001 2020-05-19
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497212260 Catrina Renee Grugin Registered Nurse Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 2019-02-27
1801307681 Bianca Gomez Dental Assistant Bldg 9900 Lincoln Street, Jblm, WA 98431 2017-10-19
1184133225 Darren Paris Registered Nurse Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 2017-09-20
1922538206 Sarah Frerichs Dentist Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 2017-06-19
1740736495 Misty Hill Dental Assistant 9119 Mill Park Ave, Tacoma, WA 98431 2016-08-31
1336695535 Jacqueline D Massouda Dentist Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 2016-08-28
1609239375 Gregg V Palmer Licensed Practical Nurse 17th and C Street, Bldg 11582, Tacoma, WA 98431 2016-03-31
1114323904 Deanna Sheets Nurse Practitioner 911 Mil Park Ave, Tacoma, WA 98431 2014-11-06
1679905434 Austin William Schaar Dentist Building 9900, 2nd Floor, Tacoma, WA 98431 2013-08-05
1518209758 Maurice Ibrahim Khayat Internal Medicine 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 2013-03-26
Find all providers in zip 98431

Taxonomy Information

Taxonomy Code 213ES0103X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Foot & Ankle Surgery

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265844385 Kaitlyn Leigh Laube Ward Podiatrist 7808 Pacific Ave Ste 1, Tacoma, WA 98408 2014-05-22
1245379486 W Joseph Barrett Podiatrist 2811 S 12th St, Tacoma, WA 98405-2746 2007-02-05
1407886617 Rebecca E Brickman Podiatrist 7808 Pacific Ave 1, Tacoma, WA 98408-7039 2006-07-04
1124085709 Eric Edward Leonheart Podiatrist 9040 Jackson Avenue Madigan Army Medical Center, Tacoma, WA 98431-5820 2006-04-27
1508825449 Ha Quang Nguyen Podiatrist 1206 S 11th St, Bldg 2, Tacoma, WA 98405-4099 2006-03-20
1396740254 Dennis Huang Podiatrist Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431-0001 2005-06-16
1144756677 Chalee Yimyam Podiatrist 9040 Jackson Ave, Tacoma, WA 98431-7711 2017-05-03
1679926398 Kyle Kenoyer Podiatrist 7808 Pacific Ave Ste 1, Tacoma, WA 98408-7039 2016-07-18
1619270923 Jacob Dean Thompson Podiatrist 9040-a Fitzsimmons Dr, Tacoma, WA 98431-1100 2010-12-08
1386970879 Franciscan Medical Group Podiatrist 2420 S Union Ave, Ste 300, Tacoma, WA 98405-1322 2009-10-19
Find all providers in TACOMA

Competitor

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City TACOMA
Zip Code 98431

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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