Bayshore Podiatry Center Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

BAYSHORE PODIATRY CENTER INC

Doing business as

Bayshore Podiatry Center

Practice address

508 S Habana Ave
230
Tampa, FL 33609-4181

Phone

(813) 877-6636

Fax

(813) 877-6636

NPI assigned

Nov 28, 2005

Organization subpart

No

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

Authorized official

Name

James Edward Repko, DPMNPI 1134537384

Title

President

Phone

(813) 877-6636

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Bayshore Podiatry Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Tax ID family

Bayshore Podiatry Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bayshore Podiatry Center

  • Sports Medicine Podiatrist
  • Tampa, FL
  • NPI 1982688354
  NPD tax ID

Locations

Practitioners 3

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

• James Edward Repko, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
  • NPI 1134537384
  Medicare reassignment Care Compare group NPD Authorized official
• Saleena Ruth Niehaus, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
  • NPI 1053717181
  Medicare reassignment Care Compare group NPD
• Scott Frederick Parratto, DPM

  • Podiatrist
  • Stuart, FL
  • NPI 1831177278
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1093798704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE",
            "address_2": "SUITE 230",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094181",
            "telephone_number": "813-877-6636",
            "fax_number": "813-877-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE",
            "address_2": "230",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094181",
            "telephone_number": "813-877-6636",
            "fax_number": "813-877-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE PODIATRY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "REPKO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-877-6636",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P02913",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029670800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayshore Podiatry Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayshore Podiatry Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bayshore Medical Group P L
• Bayshore Nutrition LLC
• Bayshore Orthodontics PLLC
• Bayshore Pediatric Dentistry and Orthodontics PLLC
• Bayshore Podiatry Center
• Bayside Breeze Therapy LLC
• Bayside Family Eyecare
• Bayside Family Healthcare Clinic
• Bayside Infusion Services, LLC
• Bayside Injury Center LLC

• Foot & Ankle Surgery Podiatrist in Tampa, FL
• Providers in Tampa, 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 Oct 23, 2024; 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.