Organization Active NPI

Foot and Ankle Institute of Colorado, PC

  • Foot & Ankle Surgery Podiatrist
  • Colorado Springs, CO
National Provider Identifier
1003294083
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
707 Issued in CO
Legal business name
FOOT AND ANKLE INSTITUTE OF COLORADO, PC
Practice address
1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone
(719) 488-4664
Fax
(719) 488-4667
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Matthew Diehl Hinderland, D.P.M.NPI 1003050899
Title
Podiatrist
Phone
(719) 488-4664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 707 CO Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945

Mailing address

1465 Kelly Johnson Blvd Ste 100
Colorado Springs, CO 80920-3945
Phone (719) 488-4664

Other identifiers 1

IdentifierTypeStateIssuer
40585042MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150608000140 CO Part B Supplier - Clinic/Group Practice 5395066013 Receives reassigned benefits from 5 practitioners
Practice locations: Colorado Springs, CO
O20150824002298 CO DME Supplier - Physician - Podiatry 5395066013 Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1003294083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-488-4664",
            "fax_number": "719-488-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203945",
            "telephone_number": "719-488-4664",
            "fax_number": "719-488-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE INSTITUTE OF COLORADO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "HINDERLAND",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DIEHL",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "719-488-4664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40585042",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.