Individual provider Active NPI

Stephen Wigley IV, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • North Miami Beach, FL
National Provider Identifier
1184913097
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3625 Issued in FL
Practice address
1595 NE 163Rd St
North Miami Beach, FL 33162-4717
Phone
(305) 895-9528
Fax
(786) 332-3242
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO3625 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO3625 FL Primary

Addresses

Primary practice location

1595 NE 163Rd St
North Miami Beach, FL 33162-4717

Mailing address

1595 NE 163Rd St
North Miami Beach, FL 33162-4717
Phone (305) 895-9528

Other identifiers 1

IdentifierTypeStateIssuer
010794200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703000836 FL Practitioner - Podiatry 3577788660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1595 NE 163Rd St
North Miami Beach, FL 33162-4717
Phone (305) 895-9528

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue124
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3625FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wigley Foot and Ankle, LLC Foot & Ankle Surgery CurrentSince Jul 1, 2014 Accepting new patients
Wigley Foot and Ankle, LLC Foot & Ankle Surgery Current Accepting new patients
Wigley Surgical Group Current Accepting new patients

Locations

1595 NE 163rd St
North Miami Beach, FL 33162
Phone (305) 895-9528

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1184913097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624717",
            "telephone_number": "305-895-9528",
            "fax_number": "786-332-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624717",
            "telephone_number": "305-895-9528",
            "fax_number": "786-332-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGLEY",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO3625",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010794200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.