JEROME M PRIVITERA DPM INC. NPI 1700969102

NPI Information

NPI: 1700969102
Provider Name: JEROME M PRIVITERA DPM, INC.
Classification: Podiatrist - 213ES0103X
Specialization: Foot & Ankle Surgery
Entity Type: Organization
Address: 9485 MENTOR AVE
SUITE 200
MENTOR, OH
ZIP 44060
Phone: (440) 205-5878

Map and Directions

Get Directions

NPI Details

JEROME M PRIVITERA DPM, INC. is a foot and ankle surgery podiatrist in Mentor, OH. JEROME M PRIVITERA DPM, INC. NPI is 1700969102. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9485 MENTOR AVE
SUITE 200
MENTOR, OH
ZIP 44060-723
Phone: (440) 205-5878
Fax: (440) 205-5875

The provider's authorized official is Jerome M Privitera .
The authorized official title is Owner and has the following contact phone number (440) 205-5878.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 10/15/2012.

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	213EP1101X	Podiatrist	Primary Podiatric Medicine	OH001535	OHIO	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	OH002454	OHIO	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	2310654	MEDICAID	OHIO
2	2310663	MEDICAID	OHIO
3	9321602	MEDICARE ID-TYPE UNSPECIFIED	OHIO	44057
4	9321601	MEDICARE ID-TYPE UNSPECIFIED	OHIO	44060
5	2310636	MEDICAID	OHIO
6	5673160001	MEDICARE NSC	OHIO

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI