Individual provider Active NPI

Kristi Linn Conway, DPM

  • Foot & Ankle Surgery Podiatrist
  • Brandon, FL
National Provider Identifier
1114964558
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2913 Issued in FL
Practice address
1149 Professional Park Drive
Brandon, FL 33511-0000
Phone
(813) 685-3668
Fax
(813) 685-5430
NPI assigned
Jun 2, 2006
Last updated
May 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO2913 FL Primary
Foot Surgery Podiatrist 213ES0131X PO2913 FL

Addresses

Primary practice location

1149 Professional Park Drive
Brandon, FL 33511-0000

Mailing address

1149 Professional Park Dr
Brandon, FL 33511-4887
Phone (813) 685-3668

Other identifiers 1

IdentifierTypeStateIssuer
340208800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090915000613 FL Practitioner - Podiatry 3476609520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kristi L Conway DPM PAGroup PAC ID 5799831855, 2 clinicians

Practice addresses (Care Compare)

1149 Professional Park Dr
Brandon, FL 33511-4868

1149 Professional Park Dr
Brandon, FL 33511-4887
Phone (813) 685-3668

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of skin lesions1-10
Removal of nail tissue11
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristi L Conway DPM PA Foot & Ankle Surgery CurrentSince Sep 1, 2009 Accepting new patients
Bayshore Podiatry Center PastSince Aug 2, 2020 Accepting new patients

Locations

1149 Professional Park Dr
Brandon, FL 33511
Phone (813) 685-3668

Interoperability endpoints

  • Direct secure messaging: kconway@bapc.emadirect.md
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1114964558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-685-3668",
            "fax_number": "813-685-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 PROFESSIONAL PARK DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335110000",
            "telephone_number": "813-685-3668",
            "fax_number": "813-685-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "KRISTI",
        "middle_name": "LINN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2913",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO2913",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340208800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.