NPIMap

Organization Active NPI

Foot & Ankle Specialists of Arizona PLLC

  • Foot & Ankle Surgery Podiatrist
  • Sun City West, AZ
National Provider Identifier
1003436635
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
Practice address
13949 W Meeker Blvd Ste B
Sun City West, AZ 85375-4436
Phone
(623) 544-9090
Fax
(623) 546-3704
NPI assigned
Apr 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Seth Clark, DPM
Title
Owner Provider
Phone
(623) 544-9090

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

13949 W Meeker Blvd Ste B
Sun City West, AZ 85375-4436

Mailing address

18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045
Phone (623) 544-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200512000122 AZ DME Supplier - Physician - Podiatry 7113359555 Practice locations: Sun City West, AZ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Foot Ankle Spec of Az PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1003436635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F168",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086045",
            "telephone_number": "623-544-9090",
            "fax_number": "623-546-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13949 W MEEKER BLVD STE B",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853754436",
            "telephone_number": "623-544-9090",
            "fax_number": "623-546-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "623-544-9090",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.