NPIMap

Organization Active NPI

Balance Foot and Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • Medina, OH
National Provider Identifier
1013686690
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BALANCE FOOT AND ANKLE LLC
Practice address
4071 N Jefferson St
Medina, OH 44256-5622
Phone
(216) 658-0111
NPI assigned
Sep 8, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BALANCE FOOT AND ANKLE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Jennifer Lynne Prezioso, DPMNPI 1235390055
Title
Owner
Phone
(216) 658-0111

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 Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

4071 N Jefferson St
Medina, OH 44256-5622

Mailing address

14200 Madison Ave
Lakewood, OH 44107-4510
Phone (216) 658-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210927000458 OH DME Supplier - Physician - Podiatry 1153607445 Practice locations: Medina, OH

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Balance Foot and Ankle LLC12 organizations share this tax ID, including this one
Part of
Balance Foot and Ankle LLC

Other organizations with this tax ID 11

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

Locations

14200 Madison Ave
Lakewood, OH 44107
Phone (330) 637-0348

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1013686690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074510",
            "telephone_number": "216-658-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 N JEFFERSON ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565622",
            "telephone_number": "216-658-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE FOOT AND ANKLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALANCE FOOT AND ANKLE LLC",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "PREZIOSO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-658-0111",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.