NPIMap

Organization Active NPI

Orlando Foot and Ankle Clinic Inc

Doing business as Orlando Foot & Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Clermont, FL
National Provider Identifier
1053420836
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ORLANDO FOOT AND ANKLE CLINIC INC
Doing business as
Orlando Foot & Ankle Clinic
Practice address
1381 Citrus Tower Blvd
Ste 103
Clermont, FL 34711
Phone
(352) 243-7066
Fax
(352) 243-7008
NPI assigned
Aug 29, 2006
Last updated
Aug 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Gregory Renton
Title
Ceo
Phone
(407) 423-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

1381 Citrus Tower Blvd
Ste 103
Clermont, FL 34711

Mailing address

P O Box 140233
Orlando, FL 32814-0233
Phone (407) 423-1234

Other identifiers 2

IdentifierTypeStateIssuer
029602300MedicaidFL
DB3528OtherFLR/R MEDICARE

Other names 1

  • Orlando Foot & Ankle Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040326000171 FL Part B Supplier - Clinic/Group Practice 6709778632 Receives reassigned benefits from 20 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Park, FL; Winter Garden, FL; Saint Cloud, FL; Oviedo, FL; Orlando, FL; Ocoee, FL; Melbourne, FL; Lake Mary, FL…
O20100930017167 FL DME Supplier - Physician - Podiatry 6709778632 Practice locations: Clermont, FL

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Orlando Foot and Anklec12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1053420836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 140233",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328140233",
            "telephone_number": "407-423-1234",
            "fax_number": "407-517-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 CITRUS TOWER BLVD",
            "address_2": "STE 103",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-243-7066",
            "fax_number": "352-243-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO FOOT AND ANKLE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "RENTON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-423-1234"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029602300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "DB3528",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orlando Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.