MEDICARE: MR. JOHN M. DEPALMA D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	MD002233	NJ
2	213E00000X	Podiatrist	25MD00223300	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	480034600	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	220463	OTHER	VSFHP
2	0763611000	OTHER	AMERIHEALTH HMO
3	223434672	OTHER	AMER. PREFERRED PROVIDER
4	223434672	OTHER	DIRECT CARE AMERICA
5	00000089143	OTHER	BETTER HEALTH ADVANTAGE
7	317027	OTHER	DIVON
8	0000616345	OTHER	BC/BS PERSONAL CHOICE
9	0762611000	OTHER	KEYSTONE - EAST
10	0763611000	OTHER	AMERIHEALTH POS
11	0763611000	OTHER	AMERIHEALTH PERSONAL CH
12	0763611000	OTHER	AMERIHEALTH PPO
13	F17329	OTHER	HEALTH NET
14	0000616345	OTHER	AMERIHEALTH ADMINISTRATOR
15	4623650001	OTHER	HEALTH NOW
16	8982930	OTHER	CIGNA

General Provider Information

NPI Number	:	1205828787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN M. DEPALMA D.P.M.

Provider Business Mailing Address
First Line	:	520 STOKES ROAD
Second Line	:	SUITE C-5
City	:	MEDFORD
State	:	NJ
Zip	:	08055
Country	:	US
Telephone Number	:	609-714-0052
Fax Number	:	609-714-3087

Provider Business Practice Location Address
First Line	:	520 STOKES ROAD
Second Line	:	SUITE C-5
City	:	MEDFORD
State	:	NJ
Zip	:	08055
Country	:	US
Telephone Number	:	609-714-0052
Fax Number	:	609-714-3087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	11/24/2015

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Directions to “ MR. JOHN M. DEPALMA D.P.M.” Practice Location

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