Organization Active NPI

Water Oak Foot and Ankle Surgery

  • Foot & Ankle Surgery Podiatrist
  • Mansfield, TX
National Provider Identifier
1093308983
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
WATER OAK FOOT AND ANKLE SURGERY
Practice address
2270 Matlock Rd Ste 104
Mansfield, TX 76063-3710
Phone
(325) 480-2063
Fax
(702) 514-6292
NPI assigned
Feb 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Matthew McCabe, DPMNPI 1235584004
Title
President
Phone
(702) 630-1905

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2270 Matlock Rd Ste 104
Mansfield, TX 76063-3710

Mailing address

2270 Matlock Rd Ste 104
Mansfield, TX 76063-3710
Phone (325) 480-2063

Other practice location 1

1900 Matlock Rd Ste 304
Mansfield, TX 76063-4435
Phone (702) 630-1905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210510000440 TX Part B Supplier - Clinic/Group Practice 9234548983 Receives reassigned benefits from 1 practitioner
Practice locations: Mansfield, TX

National Provider Directory

National Provider Directory

Locations

2270 Matlock Rd
Mansfield, TX 76063

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1093308983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 MATLOCK RD STE 104",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633710",
            "telephone_number": "325-480-2063",
            "fax_number": "702-514-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 MATLOCK RD STE 104",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633710",
            "telephone_number": "325-480-2063",
            "fax_number": "702-514-6292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Matlock Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760634435",
            "country_code": "US",
            "telephone_number": "702-630-1905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WATER OAK FOOT AND ANKLE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-09-06",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "MCCABE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-630-1905",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.