MARIO NATALE PONTICELLO DPM NPI 1134395734

NPI Information

NPI: 1134395734
Provider Name: MARIO NATALE PONTICELLO, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
9040 JACKSON AVE
TACOMA, WA
ZIP 98431
Phone: (253) 968-3505
Get Directions

Mario Natale Ponticello, DPM is a foot and ankle surgery podiatrist in Tacoma, WA. Mario Natale Ponticello, DPM NPI is 1134395734. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9040 JACKSON AVE
TACOMA, WA
ZIP 98431-001
Phone: (253) 968-3505

The NPI 1134395734 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/3/2008 and was last updated on 1/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	950-25	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00695367	OTHER	WISCONSIN	RAIL ROAD MEDICARE
2	43244600	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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