Individual provider Active NPI

Craig Sapenoff, DPM

  • Primary Podiatric Medicine Podiatrist
  • West Palm Beach, FL
National Provider Identifier
1013919802
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
PO2872 Issued in FL
Practice address
4678 Okeechobee Blvd
West Palm Beach, FL 33417-4624
Phone
(561) 689-1414
Fax
(561) 689-1993
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO2872 FL Primary

Addresses

Primary practice location

4678 Okeechobee Blvd
West Palm Beach, FL 33417-4624

Mailing address

4678 Okeechobee Blvd
West Palm Beach, FL 33417-4624
Phone (561) 689-1414

Other identifiers 1

IdentifierTypeStateIssuer
340309200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000657 FL Practitioner - Podiatry 7719049238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sapenoff and Harris PAGroup PAC ID 8729140249, 2 clinicians

Practice addresses (Care Compare)

4678 Okeechobee Blvd
West Palm Beach, FL 33417-4624

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue44
Removal of skin lesions1-10
Removal of nail tissue338
Removal or shaving of skin growth53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO2872FLMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Technology Network Inc CurrentSince Apr 9, 2021 Accepting new patients

Locations

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

Networks

  • FL HMO
  • FL PPO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1013919802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4678 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174624",
            "telephone_number": "561-689-1414",
            "fax_number": "561-689-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4678 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174624",
            "telephone_number": "561-689-1414",
            "fax_number": "561-689-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPENOFF",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO2872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340309200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.