Nathaniel A Ptak

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD001108 Issued in AZ

Practice address

5750 E Highway 90 Ste 200
Sierra Vista, AZ 85635-9113

Phone

(520) 263-3761

Fax

(520) 263-3779

NPI assigned

Jul 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, AZ2 enrollments

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 2

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sierra Vista Regional Health Center Medical Group LLCGroup PAC ID 3779732854, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Canyon Vista Medical Center Hospital, Sierra Vista, AZ, CCN 030043
• Benson Hospital Hospital, Benson, AZ, CCN 031301

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sierra Vista Regional Health Center Medical Group LLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1043575483

  Podiatrist

  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Podiatrist

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benson Hospital Corporation

  • Critical Access Hospital
  • Benson, AZ
  • NPI 1336118322
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  • Rural Health Clinic/Center
  • Sonoita, AZ
  • NPI 1013160290

  Hospital

  Care Compare affiliation
• RCHP-Sierra Vista Inc

  • General Acute Care Hospital
  • Sierra Vista, AZ
  • NPI 1194766543
  Care Compare affiliation
• RCHP-Sierra Vista Inc

  • Rural Health Clinic/Center
  • Tombstone, AZ
  • NPI 1508010471

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1194387571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 E HIGHWAY 90 STE 200",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359113",
            "telephone_number": "520-263-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 E HIGHWAY 90 STE 200",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359113",
            "telephone_number": "520-263-3761",
            "fax_number": "520-263-3779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075701",
            "country_code": "US",
            "telephone_number": "801-507-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1670 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PTAK",
        "first_name": "NATHANIEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-05",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "UT",
            "license": "12366058-0501",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "POD001108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Eugene Powers Jr., FNP-BC
• Corey Poynor-Dunning
• Prevencare Health Services, LLC
• Angela E Price, PHARMD
• Marsha A Prince, WHCNP
• Pueblo del Sol Dental Care LLC
• Raul E Quilihua Jr.
• Michelle Joy Soliven Rabara, PA-C
• Elizabeth Karen Racicot, LCSW
• Radiologists of Sierra Vista PLLC

• Foot & Ankle Surgery Podiatrist in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.