Dr. Jay Marc Mickenberg
DPM | Podiatrist | 36+ years Exp
Medicare Enrolled
8094 Edwin Raynor Blvd, Suite C, Pasadena
Maryland, 21122-6834
410-255-0040 410-360-4955
Maps & DirectionsDr. Jay Marc Mickenberg is a Pasadena, Maryland based podiatrist with 36 years of experience in Podiatry. He completed his graduation from Temple University School Of Podiatric Medicine in 1989. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Dr. Jay Marc Mickenberg for Podiatry is 1053 in Maryland.
Dr. Jay Marc Mickenberg is qualified with a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. He diagnose and treat foot diseases and deformities. He can perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Complete Profile:
Dr. Jay Marc Mickenberg speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Specialization: | Podiatry |
| Credentials: | DPM |
| Experience: | 36+ years |
| Medical School Attended: | Temple University School Of Podiatric Medicine |
| Graduation Year: | 1989 |
| Gender: | Male |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 8094 Edwin Raynor Blvd, Suite C, Pasadena,
Maryland, 21122-6834 |
| Phone: | 410-255-0040 |
| Fax: | 410-360-4955 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 1052424868 |
| Enrollment ID: | I20110511000034 |
| NPI Number: | 1336149962 |
| NPI Enumeration Date: | 26 Jul, 2005 |
| NPI Last Update On: | 21 Feb, 2024 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Jay Marc Mickenberg are as mentioned below.
| License Number | Specialization | State | Status | |
| 1053 | Podiatry | Maryland | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Jay Marc Mickenberg such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| T276 | Other | Maryland | BC/BS OF MD |
| 062308301 | Medicaid | Maryland | |
| 521617469 | Other | | UNITED HEALTHCARE |
| B765 001 | Other | | BC/BS FEDERAL |
| 1338463 | Other | | CIGNA PPO/HMO |
| 521617469 | Other | | EMPLOYER HEALTH INSURANCE |
| 521617469 | Other | | COVENTRY |
| 521617469 | Other | | FIRST HEALTH |
| 521617469 | Other | | MAMSI |
| 521617469 | Other | | TRICARE |
| 217484 | Other | | ALLIANCE |
| 521617469 | Other | | EHP |
| B765 | Other | Maryland | BLUE CHOICE |
| 217484 | Other | | MDIPA/OPTIMUM CHOICE |
| 480012800 | Other | | RAILROAD MEDICARE |
| 521617469 | Other | | CIGNA HEALTHCARE OPEN ACC |
| 521617469 | Other | | FIDELITY |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 8094 Edwin Raynor Blvd, Suite C
Pasadena, Maryland |
| Zip: | 21122-6834 |
| Phone Number: | 410-255-0040 |
| Fax Number: | 410-360-4955 |
Patients can reach Dr. Jay Marc Mickenberg at
8094 Edwin Raynor Blvd, Suite C, Pasadena, Maryland or can
call to book an appointment on 410-255-0040.
Comments/ Reviews:
Patients can read all the reviews posted for Dr. Jay Marc Mickenberg below. You may also share your own experience like the quality of treatment, behavior, and overall care provided by Dr. Jay Marc Mickenberg. It will help others make informed decisions.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.