Dr. Jay Marc Mickenberg is a Pasadena, Maryland based male podiatrist with 35 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:
Podiatrist
Credentials:
DPM
Experience:
35+ 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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.