Individual provider Active NPI

John David Fetzer, DPM

  • Foot Surgery Podiatrist
  • Akron, OH
National Provider Identifier
1194712620
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
36.002423 Issued in OH
Practice address
335 E Waterloo Rd
Akron, OH 44319-1218
Phone
(330) 724-8689
Fax
(330) 724-5470
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 36.002423 OH Primary

Addresses

Primary practice location

335 E Waterloo Rd
Akron, OH 44319-1218

Mailing address

335 E Waterloo Rd
Akron, OH 44319-1218
Phone (330) 724-8689

Other identifiers 2

IdentifierTypeStateIssuer
0537460001OtherMEDICARE NSC
0689974MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20101111000777 OH Practitioner - Podiatry 4183751795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Akron Ambulatory Foot Surgeons IncGroup PAC ID 7517009731, 3 clinicians

Practice addresses (Care Compare)

335 E Waterloo Rd
Akron, OH 44319-1218
Phone (330) 724-8689

Merit-based Incentive Payment System (MIPS)

Final score
13.47 of 100Reported as individual
Quality
24.63
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue60
Removal of skin lesions1-10
Removal of nail tissue750
Removal or shaving of skin growth116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2423OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Ambulatory Foot Surgeons Inc Foot Surgery CurrentSince Apr 1, 1998 Accepting new patients
Akron Podiatry Assoc. Inc Foot Surgery PastSince Feb 1, 2002 Accepting new patients

Locations

335 E Waterloo Rd
Akron, OH 44319
Phone (216) 724-8689

20 South Ave
Tallmadge, OH 44278
Phone (216) 630-9030

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/60151f1c-ed83-486a-b2ca-e2046f99f575/

Organizations & group practices 2

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1194712620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E WATERLOO RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443191218",
            "telephone_number": "330-724-8689",
            "fax_number": "330-724-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E WATERLOO RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443191218",
            "telephone_number": "330-724-8689",
            "fax_number": "330-724-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETZER",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OH",
            "license": "36.002423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "0537460001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0689974",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.