Individual provider Active NPI

Pamela S Dolber, DPM

  • Podiatrist
  • Lake Placid, FL
National Provider Identifier
1023013679
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2842 Issued in FL
Practice address
3 S Main Ave
Lake Placid, FL 33852-1806
Phone
(863) 699-0710
Fax
(863) 699-0710
NPI assigned
Jun 19, 2005
Reactivated
Mar 27, 2006
Last updated
Nov 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO2842 FL Primary

Addresses

Primary practice location

3 S Main Ave
Lake Placid, FL 33852-1806

Mailing address

4126 Loretto Ave
Sebring, FL 33872-1917
Phone (863) 385-0571

Other identifiers 2

IdentifierTypeStateIssuer
59354208MedicaidCO
340365300MedicaidFL

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
I20040922001058 FL Practitioner - Podiatry 0446228878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3 S Main Ave
Lake Placid, FL 33852-1806
Phone (863) 699-0710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue163
Removal of skin lesions1-10
Removal of nail tissue572
Removal or shaving of skin growth48
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000894GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pamela S Dolber DPM PA CurrentSince Apr 1, 2005 Accepting new patients
KG Health Partners, Inc Podiatrist PastSince Nov 5, 2012 Accepting new patients
Sebring Podiatry Center Inc Past Accepting new patients

Locations

3 S Main Ave
Lake Placid, FL 33852
Phone (863) 699-0710

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: pdolber@dolber.mdlogic.direct-ci.com

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1023013679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 LORETTO AVE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721917",
            "telephone_number": "863-385-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S MAIN AVE",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338521806",
            "telephone_number": "863-699-0710",
            "fax_number": "863-699-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLBER",
        "first_name": "PAMELA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-19",
        "last_updated": "2009-11-02",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59354208",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340365300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, FL

Sources for this page

Verify at the official NPI Registry.