NPIMap

Organization Active NPI

Balance: Foot and Ankle, LLC

  • Foot & Ankle Surgery Podiatrist
  • Sheffield Village, OH
National Provider Identifier
1124797709
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 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
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BALANCE: FOOT AND ANKLE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

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

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: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

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

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Balance Foot and Ankle LLC12 organizations share this tax ID, including this one
Part of
Balance Foot and Ankle LLC

Other organizations with this tax ID 11

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

Locations

14200 Madison Ave
Lakewood, OH 44107
Phone (330) 637-0348

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.