Dr Jonathan Detommaso, DPM | |
7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | |
(260) 436-8686 | |
(260) 436-8585 |
Full Name | Dr Jonathan Detommaso |
---|---|
Gender | Male |
Speciality | Podiatry |
Experience | 12 Years |
Location | 7601 W Jefferson Blvd, Fort Wayne, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033476304 | NPI | - | NPPES |
P01524125 | Other | IN | RAILROAD MEDICARE |
201289140 | Medicaid | IN | |
000000934131 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 07001204A (Indiana) | Secondary |
213ES0103X | Podiatrist - Foot & Ankle Surgery | 07001204A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
The Orthopaedic Hospital Of Lutheran Health Networ | Fort wayne, IN | Hospital |
Lutheran Hospital Of Indiana | Fort wayne, IN | Hospital |
Cameron Memorial Community Hospital Inc | Angola, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Fort Wayne Orthopaedics, Llc | 7618965286 | 55 |
Provider Name | Fort Wayne Orthopaedics, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1497758429 PECOS PAC ID: 7618965286 Enrollment ID: O20120613000331 |
Mailing Address | Practice Location Address |
---|---|
Dr Jonathan Detommaso, DPM Po Box 2526, Fort Wayne, IN 46801-2526 Ph: (866) 401-3663 | Dr Jonathan Detommaso, DPM 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 Ph: (260) 436-8686 |
Lafayette Foot And Ankle Clinic Podiatrist Medicare: Medicare Enrolled Practice Location: 2700 Lafayette St Ste 230, Fort Wayne, IN 46806 Phone: 260-458-9953 Fax: 260-458-9238 | |
Lafayette Foot & Ankle Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 2700 Lafayette St, Suite 100, Fort Wayne, IN 46806 Phone: 260-458-9953 Fax: 260-458-9238 | |
Gage Manning Caudell, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585 | |
Dr. Dominick Detommaso, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 7601 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-436-8686 Fax: 260-436-8585 | |
Waynedale Foot Clinic Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 6200 Bluffton Rd, Fort Wayne, IN 46809 Phone: 260-747-5572 Fax: 260-747-8392 | |
Dr. David K Wysong, DPM Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 3012 E State Blvd, Fort Wayne, IN 46805 Phone: 260-471-6830 Fax: 260-471-6704 |