Organization Active NPI

Foot and Ankle Specialists of Clearwater, LLC

  • Foot & Ankle Surgery Podiatrist
  • Clearwater, FL
National Provider Identifier
1154010056
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT AND ANKLE SPECIALISTS OF CLEARWATER, LLC
Practice address
4625 E Bay Dr Ste 106
Clearwater, FL 33764-6866
Phone
(727) 434-4468
NPI assigned
May 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Asma KhanNPI 1659518264
Title
Administrator
Phone
(773) 550-8401

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

4625 E Bay Dr Ste 106
Clearwater, FL 33764-6866

Mailing address

4625 E Bay Dr Ste 106
Clearwater, FL 33764-6866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240613000666 FL Part B Supplier - Clinic/Group Practice 6800338278 Receives reassigned benefits from 1 practitioner
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

4625 E Bay Dr
Ste 106
Clearwater, FL 33764
Phone (727) 400-4073

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": "1683244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1154010056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 E BAY DR STE 106",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 E BAY DR STE 106",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337646866",
            "telephone_number": "727-434-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF CLEARWATER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-05",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ASMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-550-8401"
    },
    "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 Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.