NPIMap

Organization Active NPI

Healthdrive Podiatry Group, PA

  • Podiatrist
  • Houston, TX
National Provider Identifier
1104861475
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
HEALTHDRIVE PODIATRY GROUP, PA
Practice address
4201 FM 1960 Rd W
Suite # 230
Houston, TX 77068-3414
Phone
(281) 537-1599
Fax
(281) 537-1310
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Michele Lee Trbovich
Title
President/Practice Director
Phone
(214) 697-0727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

4201 FM 1960 Rd W
Suite # 230
Houston, TX 77068-3414

Mailing address

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

Other identifiers 1

IdentifierTypeStateIssuer
171674801MedicaidTX

Other names 1

  • HealthDrive Podiatry Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050302000045 TX Part B Supplier - Clinic/Group Practice 1759334782 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Worth, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

8069 Scyene Cir
Dallas, TX 75227
Phone (214) 388-0424

7001 Bryant Irvin Rd
Fort Worth, TX 76132
Phone (616) 446-0271

2500 Citywest Blvd
Ste 300
Houston, TX 77042
Phone (281) 520-4435

2101 W Northgate Dr
Irving, TX 75062
Phone (972) 255-4460

1241 Westridge Ave
Ste 706
Lancaster, TX 75146

202 W British Flying School Blvd
Terrell, TX 75160

250 FM 2578
Terrell, TX 75160
Phone (469) 247-4700

Practitioners & affiliated clinicians

Practitioners 12

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1104861475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "617-630-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 FM 1960 RD W",
            "address_2": "SUITE # 230",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770683414",
            "telephone_number": "281-537-1599",
            "fax_number": "281-537-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHDRIVE PODIATRY GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "TRBOVICH",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT/PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "214-697-0727"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171674801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.