BLAIR MOYLE JOLLEY DPM
NPI 1366737728
Podiatrist - Foot & Ankle Surgery in Panorama City, CA

Q: What is the provider's specialty?

The provider's specialty is Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

Active since June 14, 2011PECOS EnrolledAccepts Medicare Assignment

13652 CANTARA ST, PANORAMA CITY, CA 91402(818) 375-2000(818) 375-3201 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 1, 2021, Feb 5, 2016, Jan 22, 2016 (3 updates tracked since 2016).

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About Blair Moyle Jolley Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAIR MOYLE JOLLEY DPM (NPI 1366737728) is an individual foot & ankle surgery provider in Panorama City, California, licensed in California (E5135) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2011).

NPPES Registry Identity

NPI1366737728

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameBLAIR MOYLE JOLLEYCredential: DPM

Location Address13652 CANTARA STPanorama City, CA 91402-5423

Mailing Address13652 Cantara StPanorama City, CA 91402-5423 · (818) 375-2000 · Fax (818) 375-3201

Phone(818) 375-2000

Fax(818) 375-3201

Sole ProprietorNo

Medical School CMSTemple University School Of MedicineGraduated 2011

Enumeration DateJune 14, 2011

Last NPPES UpdateDecember 1, 20213 updates tracked since enumeration

✔ NPI 1366737728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in CA · E5135

13652 CANTARA ST, Panorama City, CA 91402

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Blair Moyle Jolley Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224344585

PECOS Enrollment IDI20150901001372

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.