Provider Demographics
NPI:1841492204
Name:PIRAINO, JASON ANTHONY (DPM MS)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ANTHONY
Last Name:PIRAINO
Suffix:
Gender:M
Credentials:DPM MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-6330
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-8203
Practice Address - Fax:904-244-3457
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005687213E00000X
FLPO3627213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019149600001Medicaid
PA7204911OtherAETNA PPO
PA1662211OtherAETNA HMO
PAPI1975124OtherBLUE CROSS BLUE SHIELD
PA231365971OtherOXFORD
PA231365971OtherUNITED HEALTH CARE
PA28824OtherHEALTH PARTNERS
GA003136825AMedicaid
FL009391100Medicaid
PA17565OtherELDER HEALTH/BRAVO
PA2853968000OtherKEYSTONE HEALTH PLAN EAST
PA31776OtherKEYSTONE MERCY
PA3533214OtherCIGNA
PA1662211OtherAETNA HMO
PA113579NSGMedicare PIN