Basic Information
| Provider Information | |||||||||
| NPI: | 1841492204 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIRAINO | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 44008 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322314008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042446330 | ||||||||
| FaxNumber: | 9042443425 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 W 8TH ST | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322096511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042448203 | ||||||||
| FaxNumber: | 9042443457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2007 | ||||||||
| LastUpdateDate: | 01/27/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | SC005687 | PA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213E00000X | PO3627 | FL | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 1019149600001 | 05 | PA | MEDICAID | 7204911 | 01 | PA | AETNA PPO | OTHER | 1662211 | 01 | PA | AETNA HMO | OTHER | PI1975124 | 01 | PA | BLUE CROSS BLUE SHIELD | OTHER | 231365971 | 01 | PA | OXFORD | OTHER | 231365971 | 01 | PA | UNITED HEALTH CARE | OTHER | 28824 | 01 | PA | HEALTH PARTNERS | OTHER | 003136825A | 05 | GA | MEDICAID | 009391100 | 05 | FL | MEDICAID | 17565 | 01 | PA | ELDER HEALTH/BRAVO | OTHER | 2853968000 | 01 | PA | KEYSTONE HEALTH PLAN EAST | OTHER | 31776 | 01 | PA | KEYSTONE MERCY | OTHER | 3533214 | 01 | PA | CIGNA | OTHER |