Northeast Family Foot Care, PC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

SC004123-L Issued in PA

Legal business name

NORTHEAST FAMILY FOOT CARE, PC

Practice address

9892 Bustleton Ave
Suite 303
Philadelphia, PA 19115-2184

Phone

(215) 673-3200

Fax

(215) 673-3884

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donna G. Myers, DPM

Title

Owner

Phone

(215) 673-3200

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Amy B Lustig, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
  • NPI 1902973407
  Medicare reassignment NPD

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1174739940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-673-3200",
            "fax_number": "215-673-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9892 BUSTLETON AVE",
            "address_2": "SUITE 303",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152184",
            "telephone_number": "215-673-3200",
            "fax_number": "215-673-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FAMILY FOOT CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-673-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC004123-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "GOO1124200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ANDSENIOR PARTNERS",
            "identifier": "32994",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480034747",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "2018883000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northeast Dental Center, P.C.
• Northeast Discount
• Northeast Family Medical and Rehabilitation Center, P.C
• Northeast First Aid Corps.
• Northeast Foot and Ankle Specialists, PC
• Northeast Health Center
• Northeast Imaging Associates of Philadelphia, P.C.

• Foot Surgery Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Foot Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.