Suburban Podiatry Associates, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016-003968 Issued in IL

Legal business name

SUBURBAN PODIATRY ASSOCIATES, P.C.

Practice address

303 E Army Trail Rd
Suite #101
Bloomingdale, IL 60108-2169

Phone

(630) 893-3668

Fax

(630) 893-3670

NPI assigned

Jan 9, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Martin Jansyn, D.P.M.NPI 1639250632

Title

President

Phone

(630) 893-3668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory M Jansyn, DPM

  • Primary Podiatric Medicine Podiatrist
  • Bloomingdale, IL
  • NPI 1639250632
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1294531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1073817805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE #101",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-893-3668",
            "fax_number": "630-893-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE #101",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-893-3668",
            "fax_number": "630-893-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PODIATRY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-09",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "JANSYN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-893-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-003968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.