Individual provider Active NPI

Ridvan Husic, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
National Provider Identifier
1063151280
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4618 Issued in FL
Practice address
12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone
(239) 482-2663
NPI assigned
Jun 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO4068 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO4618 FL Primary

Addresses

Primary practice location

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370

Mailing address

17 Ledyard PL
Staten Island, NY 10305-2521

Other practice location 1

350 Boulevard
Passaic, NJ 07055-2840
Phone (917) 454-8581

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
I20250701002866 FL Practitioner - Podiatry 3375056500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Center of Florida, IncGroup PAC ID 9931183639, 48 clinicians

Practice addresses (Care Compare)

12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3370
Phone (239) 482-2663

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO4068FLMDFoot & Ankle Surgery Podiatrist
PO4618FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Center of Florida, Inc CurrentSince Jul 1, 2025 Accepting new patients
Orthopedic Center of Florida, Inc CurrentSince Jul 1, 2025 Accepting new patients
Physicians Surgery Center LLC Past Accepting new patients

Locations

8350 Riverwalk Park Blvd
Ste 1
Fort Myers, FL 33919
Phone (239) 482-2663

12670 Creekside Ln
Ste 202
Fort Myers, FL 33919
Phone (239) 267-2263

Interoperability endpoints

  • Direct secure messaging: ridvan.husic.1@22724.direct.athenahealth.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 and National Provider Directory roles.

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": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1063151280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LEDYARD PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070552840",
            "country_code": "US",
            "telephone_number": "917-454-8581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUSIC",
        "first_name": "RIDVAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-04",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4068",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.