NPIMap

Organization Active NPI

Modern Foot & Ankle Centers, PLLC

  • Podiatrist
  • Gilbert, AZ
National Provider Identifier
1144840273
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MODERN FOOT & ANKLE CENTERS, PLLC
Practice address
2680 S Val Vista Dr Ste 177
Gilbert, AZ 85295-1674
Phone
(480) 909-3700
Fax
(877) 839-9972
NPI assigned
Apr 18, 2020
Last updated
Jul 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Dr. David Laurino, DPMNPI 1093703977
Title
Partner
Phone
(480) 909-3700

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
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

2680 S Val Vista Dr Ste 177
Gilbert, AZ 85295-1674

Mailing address

2680 S Val Vista Dr Ste 177
Gilbert, AZ 85295-1674
Phone (480) 909-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200602000168 AZ DME Supplier - Physician - Podiatry 5991126898 Practice locations: Gilbert, AZ
O20200617000703 AZ Part B Supplier - Clinic/Group Practice 5991126898 Receives reassigned benefits from 7 practitioners
Practice locations: Chandler, AZ; Gilbert, AZ

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Modern Foot Ankle2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

600 S Dobson Rd
Ste E39
Chandler, AZ 85224
Phone (480) 777-5888

2680 S Val Vista Dr
#14177
Gilbert, AZ 85295

2680 S Val Vista Dr
Ste 117
Gilbert, AZ 85295

2680 S Val Vista Dr
Ste 177
Gilbert, AZ 85295
Phone (480) 732-0033

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1144840273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR STE 177",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951674",
            "telephone_number": "480-909-3700",
            "fax_number": "877-839-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S VAL VISTA DR STE 177",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951674",
            "telephone_number": "480-909-3700",
            "fax_number": "877-839-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FOOT & ANKLE CENTERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "LAURINO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "480-909-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.