Organization Active NPI

Holtgate Podiatry, PLLC

  • Podiatrist
  • Camp Hill, PA
National Provider Identifier
1154649937
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC006019 Issued in PA
Legal business name
HOLTGATE PODIATRY, PLLC
Practice address
3560 Gettysburg Rd
Camp Hill, PA 17011-6803
Phone
(717) 731-1133
Fax
(717) 635-8385
NPI assigned
May 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Dr. Sally A Fayed, DPMNPI 1356758460
Title
Owner
Phone
(717) 731-1133

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X SC006019 PA Primary

Addresses

Primary practice location

3560 Gettysburg Rd
Camp Hill, PA 17011-6803

Mailing address

3560 Gettysburg Rd
Camp Hill, PA 17011-6803
Phone (717) 731-1133

Other identifiers 1

IdentifierTypeStateIssuer
DQ1524OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100520000423 PA Part B Supplier - Clinic/Group Practice 7911036561 Receives reassigned benefits from 2 practitioners
Practice locations: Camp Hill, PA
O20100930067944 PA DME Supplier - Physician - Podiatry 7911036561 Practice locations: Camp Hill, PA

National Provider Directory

National Provider Directory
Tax ID family
Holtgate Podiatry PLLC2 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.

Locations

717 Market St
Ste 101
Lemoyne, PA 17043
Phone (717) 731-1133

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1154649937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 GETTYSBURG RD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170116803",
            "telephone_number": "717-731-1133",
            "fax_number": "717-635-8385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 GETTYSBURG RD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170116803",
            "telephone_number": "717-731-1133",
            "fax_number": "717-635-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLTGATE PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "FAYED",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-731-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC006019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DQ1524",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.