JASON GANNON D.P.M.
NPI 1619992690
Podiatrist - Foot Surgery in Newark, NJ

Q: What is Jason Gannon's NPI number?

The NPI number for Jason Gannon is 1619992690. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Q: What is Jason Gannon's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot Surgery, with taxonomy code 213ES0131X.

Q: When was this NPI record last updated?

The NPPES record for Jason Gannon was last updated on December 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 12, 2006PECOS EnrolledAccepts Medicare Assignment

111 MULBERRY ST, SUITE 1R, NEWARK, NJ 07102(973) 818-9104 Get Directions Write a Review

NPPES record last updated: December 22, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jason Gannon D.p.m. NPPES

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

JASON GANNON D.P.M. (NPI 1619992690) is an individual foot surgery provider in Newark, New Jersey, licensed in New Jersey (25MD00257500) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of New York College Of Podiatric Medicine (1997).

NPPES Registry Identity

NPI1619992690

Entity TypeIndividualMale

Primary Taxonomy213ES0131X

Provider Legal NameJASON GANNONCredential: D.P.M.

Location Address111 MULBERRY ST, SUITE 1RNewark, NJ 07102-4008

Mailing Address131 Safran AveEdison, NJ 08837-3205 · (973) 818-9104

Phone(973) 818-9104

Sole ProprietorYes

Medical School CMSNew York College Of Podiatric MedicineGraduated 1997

Enumeration DateJuly 12, 2006

Last NPPES UpdateDecember 22, 2010

✔ NPI 1619992690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0131X

License✔ Licensed in NJ · 25MD00257500

111 MULBERRY ST, Newark, NJ 07102

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Other Identifiers 3

Medicaid8238502NJ

Medicare UPINU81534NJ

Medicare ID-Type Unspecified041359NJ

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

Jason Gannon D.p.m. 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 ID648448860

PECOS Enrollment IDI20110714000075

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

536 services177 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

310 services113 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

258 services118 patients

Removal of fingernails or toenails, 1-5 nails 11720

This procedure involves the careful removal of 1-5 nails from fingers or toes. It's typically done to treat conditions like ingrown nails, fungal infections, or damaged nails. Local anesthesia is used for comfort, and the area heals over time with appropriate care.

253 services84 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

141 services67 patients

Trimming of dystrophic nails, any number G0127

Trimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.

139 services43 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEDI-IMAGING

Radiology (Diagnostic Ultrasound)

111 MULBERRY ST, SUITE 1R
NEWARK, NJ 07102

Essex County (973) 493-3600

DR KENNETH FRANK

Podiatrist (Foot & Ankle Surgery)

111 MULBERRY ST, SUITE 1R
NEWARK, NJ 07102

Essex County (908) 810-9390

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason Gannon's NPI number?

The NPI number for Jason Gannon is 1619992690. It was assigned to this individual provider in the NPPES registry on July 12, 2006.

Where is Jason Gannon located?

Jason Gannon practices at 111 Mulberry St Suite 1R, Newark, NJ 07102. The listed phone number is (973) 818-9104.

What is Jason Gannon's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot Surgery, with taxonomy code 213ES0131X.

Is Jason Gannon enrolled in Medicare?

Yes. Jason Gannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jason Gannon was last updated on December 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.