Organization Active NPI

Proactive Podiatry Associates PLLC

  • Foot & Ankle Surgery Podiatrist
  • Monaca, PA
National Provider Identifier
1104532787
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PROACTIVE PODIATRY ASSOCIATES PLLC
Practice address
3578 Brodhead Rd
Monaca, PA 15061-3143
Phone
(724) 775-6168
NPI assigned
Jan 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Latika Hinduja, DPMNPI 1508206335
Title
President
Phone
(724) 775-6168

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

3578 Brodhead Rd
Monaca, PA 15061-3143

Mailing address

3578 Brodhead Rd
Monaca, PA 15061-3143
Phone (724) 775-6168

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230228002394 PA Part B Supplier - Clinic/Group Practice 0446623169 Receives reassigned benefits from 1 practitioner
Practice locations: Monaca, PA; Wexford, PA

National Provider Directory

National Provider Directory

Locations

3578 Brodhead Rd
Monaca, PA 15061
Phone (724) 775-6168

10475 Perry Hwy
Ste 205
Wexford, PA 15090
Phone (724) 775-6168

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": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1104532787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3578 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613143",
            "telephone_number": "724-775-6168",
            "fax_number": "724-775-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3578 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613143",
            "telephone_number": "724-775-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PODIATRY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "HINDUJA",
        "authorized_official_first_name": "LATIKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-775-6168",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monaca, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.