NPIMap

Organization Active NPI

Integrated Foot and Ankle Specialists of PA LLC

Doing business as Bryn Mawr Foot & Ankle Center

  • Podiatric Clinic/Center
  • Bryn Mawr, PA
National Provider Identifier
1184480188
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC
Doing business as
Bryn Mawr Foot & Ankle Center
Practice address
934 County Line Rd Ste 1
Bryn Mawr, PA 19010-2502
Phone
(610) 527-8655
NPI assigned
Feb 27, 2024
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Teresa Leonarda Ciaccio
Title
Chief Operating Officer
Phone
(516) 993-8666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

934 County Line Rd Ste 1
Bryn Mawr, PA 19010-2502

Mailing address

50 S 16TH St FL 17
Philadelphia, PA 19102-3530

Other names 1

  • Bryn Mawr Foot & Ankle Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241223001853 PA DME Supplier - Physician - Podiatry 1153704754 Practice locations: Bryn Mawr, PA

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Integrated Foot and Ankle Specialists of PA LLC16 organizations share this tax ID, including this one
Part of
Integrated Foot and Ankle Specialists of PA LLC

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1184480188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S 16TH ST FL 17",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 COUNTY LINE RD STE 1",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190102502",
            "telephone_number": "610-527-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "CIACCIO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LEONARDA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "516-993-8666"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryn Mawr Foot & Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.