Kristopher P Jerry, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3941 Issued in FL

Practice address

1846 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5545

Phone

(772) 301-1951

Fax

(772) 934-7297

NPI assigned

Jun 10, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Podiatry Health Services LLCGroup PAC ID 3173856556, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Podiatry Health Services LLC

  • Foot & Ankle Surgery Podiatrist
  • Port St Lucie, FL
  • NPI 1700441342
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1063861979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-301-1951",
            "fax_number": "772-934-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1846 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525545",
            "telephone_number": "772-301-1951",
            "fax_number": "772-934-7297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Stirling Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330211522",
            "country_code": "US",
            "telephone_number": "772-301-1951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "721 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349943017",
            "country_code": "US",
            "telephone_number": "772-301-1951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9950 Stirling Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330248001",
            "country_code": "US",
            "telephone_number": "954-869-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERRY",
        "first_name": "KRISTOPHER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen E Jenkins, MD
• Melissa Jenkins
• Suzanne L. Jensen, L.M.T.
• William J Jensen, D.C.
• Myralda Jerome, LMHC
• Rachel Autumn Jeter
• Mariene Jimenez Mustelier, ITDS
• Danielle Elizabeth Jimenez
• Tandy T Jipp
• JJWP LLC

• Foot & Ankle Surgery Podiatrist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.