NPIMap

Balance: Foot and Ankle, LLC

Organization Active NPI Foot & Ankle Surgery Podiatrist · Sheffield Village, OH

NPI 1124797709 · NPPES record last updated Nov 19, 2024

Key facts

NPI
1124797709
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
Legal business name
BALANCE: FOOT AND ANKLE, LLC
Practice address
5445 Detroit Rd Ste 102
Sheffield Village, OH 44054-3909
Phone
(216) 658-0111
NPI assigned
Sep 8, 2021
Organization subpart
Yes
Parent organization (as reported)
BALANCE: FOOT AND ANKLE LLC

Authorized official

Name
Jennifer Lynne Prezioso, DPM NPI 1235390055
Title
Owner
Phone
(216) 658-0111

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

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 11

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

Practitioners 12

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220517000784 OH DME Supplier - Physician - Podiatry 1153607445 Practice locations: Sheffield Village, OH

National Provider Directory

Tax ID family
Balance Foot and Ankle LLC (12 organizations share this tax ID)
Part of
Balance Foot and Ankle LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP		 213ES0103X Yes

Addresses

Primary practice location

5445 Detroit Rd Ste 102
Sheffield Village, OH 44054-3909

Mailing address

14200 Madison Ave
Lakewood, OH 44107-4510
Phone (216) 658-0111

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 19, 2024.

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1124797709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074510",
            "telephone_number": "216-658-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 DETROIT RD STE 102",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440543909",
            "telephone_number": "216-658-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE: FOOT AND ANKLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALANCE: FOOT AND ANKLE LLC",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "PREZIOSO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-658-0111",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheffield Village, OH

All providers in Sheffield Village, OH · Foot & Ankle Surgery Podiatrist in Ohio

Sources for this page

Verify at the official NPI Registry.