JOHN J DISTAZIO, D.P.M., P.C. (NPI# 1316123052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316123052 |
| Entity Type | Organization |
| Organization Name | JOHN J DISTAZIO, D.P.M., P.C. |
| Practice Address |
495 E Waterfront Drive Suite 230 Homestead PA 15120-1151 |
| Practice Telephone | 4124611108 |
| Practice Fax Number | 4124615490 |
| Mailing Telephone | 4124611108 |
| Mailing Fax Number | 4124615490 |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-04-02 |
| Authorized Official Name | JOHN J DISTAZIO (OWNER) |
| Authorized Official Telephone | 4124611108 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC002842L | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | INDIVIDUAL NPI NUMBER | 1366414088 | 01 |
| PA | 0010941370001 | 05 | |
| PA | MC GROUP PROVIDER NUMBER | 175132XXX | 01 |
| PA | MC GROUP NPI NUMBER | 1316123052 | 01 |
| PA | MEDICARE LEGACY NUMBER | 175132 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831688159 | John J Distazio, D.p.m., P.C. | Durable Medical Equipment & Medical Supplies | 640 Rodi Rd, Pittsburgh, PA 15235-4512 | 2018-05-02 |
| Street Address |
495 E WATERFRONT DRIVE SUITE 230 |
| City | HOMESTEAD |
| State | PA |
| Zip Code | 15120-1151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477505345 | Colleen Ann Happel | Nurse Anesthetist, Certified Registered | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-17 |
| 1033459425 | Kathleen M Oconnell Dpm PC | Podiatrist | 495 E Waterfront Drive, Suite 230, Homestead, PA 15120-1151 | 2013-02-21 |
| 1023062734 | Diana J Lang | Nurse Anesthetist, Certified Registered | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-19 |
| 1750335469 | Deanna M Nelson | Nurse Anesthetist, Certified Registered | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-19 |
| 1033162128 | Mark A Troiano | Anesthesiology | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-18 |
| 1740232628 | Rosemary C Lyon | Nurse Anesthetist, Certified Registered | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-17 |
| 1861444788 | Brian Melnick | Anesthesiology | 495 E Waterfront Drive, Homestead, PA 15120 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851775357 | Jie Yan | Social Worker | 1800 West Street, Pittsburgh, PA 15120 | 2015-07-14 |
| 1659620763 | Dana Kennedy | Dietitian, Registered | 491 East Eighth Ave, Homestead, PA 15120 | 2012-09-05 |
| 1093063661 | Donna Jean Kanz | Registered Nurse | 491 E. Eighth Ave, Homestead, PA 15120 | 2012-08-29 |
| 1700134301 | Annamarie Duboy | Registered Nurse | 496 E. Eighth Ave, Homestead, PA 15120 | 2012-08-29 |
| 1689922312 | Lisa Smeltzer | Registered Nurse | 491 E. Eighth Avenue, Homestead, PA 15120 | 2012-08-28 |
| 1639326762 | John C Wain | Internal Medicine | 1001 Sullivan Dr, West Homestead, PA 15120 | 2008-08-20 |
| 1801055629 | Jennifer Lynn Brown | Social Worker | 1088 West Street, 1st Floor, Homestead, PA 15120 | 2008-06-06 |
| 1184890485 | Joseph W D'alesio Dds Inc | Dentist | 4609 Main St, Munhall, PA 15120 | 2008-05-06 |
| 1407053424 | Donald Edwin, Lionel Arnold | Non-emergency Medical Transport (VAN) | 463 West 8th Avenue, West Homestead, PA 15120 | 2007-07-02 |
| 1922128347 | Erik Lee Cornell | Speech-Language Pathologist | 491 E Eigth Avenue, Homestead, PA 15120 | 2007-03-30 |
| Find all providers in zip 15120 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750723623 | Perfectfeetcare, Inc | Podiatrist | 922 N Krome Ave, Homestead, FL 33030-4409 | 2013-07-22 |
| 1033459425 | Kathleen M Oconnell Dpm PC | Podiatrist | 495 E Waterfront Drive, Suite 230, Homestead, PA 15120-1151 | 2013-02-21 |
| 1285908269 | Francis Woedje Wodie | Podiatrist | 975 Baptist Way Ste 101, Homestead, FL 33033-7600 | 2012-03-08 |
| 1225214968 | Stephen J Kruljac, D.p.m., P.C. | Podiatrist | 495 East Waterfront Drive, Suite 230, Homestead, PA 15120-1151 | 2008-01-11 |
| 1689850323 | Rodger B Kuhn, D.p.m.. P.C. | Podiatrist | 495 East Waterfront Drive, Suite 230, Homestead, PA 15120-1151 | 2008-01-11 |
| 1710912845 | Stanley D. Bosta Dpm PC | Podiatrist | 495 Waterfront Dr E, Suite230, Homestead, PA 15120-1140 | 2006-07-11 |
| 1710911912 | William H. Lenz, Dpm, PC | Podiatrist | 495 Waterfront Dr E, Suite 230, Homestead, PA 15120-1140 | 2006-07-11 |
| 1114963006 | Paul E Gregoline Dpm Pa | Podiatrist | 45 Nw 4th St, Homestead, FL 33030-5941 | 2006-06-21 |
| 1265496384 | Paul Eugene Gregoline | Podiatrist | 45 Nw 4th St, Homestead, FL 33030-5941 | 2006-04-14 |
| 1851363402 | Rodger B Kuhn | Podiatrist | 495 Waterfront Dr E, Suite 230, Homestead, PA 15120-1140 | 2006-02-07 |
| Find all providers in HOMESTEAD | ||||
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| 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.