| John J Distazio, DPM | |
| 
					495 Waterfront Dr E, Suite 230, Homestead, PA 15120-1140  | |
| (412) 461-1108 | |
| (412) 461-5490 | 
| Full Name | John J Distazio | 
|---|---|
| Gender | Male | 
| Speciality | Podiatrist - Foot & Ankle Surgery | 
| Location | 495 Waterfront Dr E, Homestead, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1366414088 | NPI | - | NPPES | 
| 0004134486 | Other | PA | AETNA PIN | 
| 1156610001 | Other | PA | DMERC PROV NUMBER | 
| 455619 | Other | PA | HIGHMARK GRP PROV NUMBER | 
| 0010941370001 | Medicaid | PA | |
| 1009921 | Other | PA | GATEWAY HMO NUMBER | 
| 1205011277 | Other | PA | DMERC NPI NUMBER | 
| 1316123052 | Other | PA | RR MEDICARE GROUP NPI | 
| 175132 | Other | PA | HIGHMARK INDIVIDUAL PROV# | 
| 175132XXX | Other | PA | MC GROUP PROV NUMBER | 
| 1316123052 | Other | PA | MC GROUP NPI NUMBER | 
| 1710911912 | Other | PA | HIGHMARK GROUP NPI NUMBER | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | SC002842L (Pennsylvania) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| John J Distazio, DPM 495 Waterfront Dr E, Suite 230, Homestead, PA 15120-1140 Ph: (412) 461-1108  | John J Distazio, DPM 495 Waterfront Dr E, Suite 230, Homestead, PA 15120-1140 Ph: (412) 461-1108  | 
Kathleen M Oconnell Dpm Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 495 E Waterfront Drive, Suite 230, Homestead, PA 15120 Phone: 412-461-1108 Fax: 412-461-5490  | |
Stanley D Bosta, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 495 Waterfront Dr E, Suite 230, Homestead, PA 15120 Phone: 412-325-0397 Fax: 412-461-5490  | |
Stephen J Kruljac, D.p.m., P.c. Podiatrist Medicare: Medicare Enrolled Practice Location: 495 East Waterfront Drive, Suite 230, Homestead, PA 15120 Phone: 412-461-1108 Fax: 412-461-5490  | |
Sara Sadeghi, DPM Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 495 E Waterfront Dr Ste 230, Homestead, PA 15120 Phone: 412-461-1108 Fax: 412-461-5490  | |
John J Distazio, D.p.m., P.c. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 495 E Waterfront Drive, Suite 230, Homestead, PA 15120 Phone: 412-461-1108 Fax: 412-461-5490  | |
Rodger B Kuhn, D.p.m.. P.c. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 495 East Waterfront Drive, Suite 230, Homestead, PA 15120 Phone: 412-461-1108 Fax: 412-461-5490  |