Organization Active NPI

Foot & Ankle Group of Southwest Florida, PA

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
National Provider Identifier
1194725002
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO-3613 Issued in FL
Legal business name
FOOT & ANKLE GROUP OF SOUTHWEST FLORIDA, PA
Practice address
7117 Congdon Rd Apt 200
Fort Myers, FL 33908-5004
Phone
(239) 936-5400
Fax
(239) 936-9572
NPI assigned
Jul 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Jerold S. GoldsteinNPI 1740251750
Title
Authorized Official
Phone
(239) 936-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X PO-1326 FL
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X PO-2020 FL
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X PO-1693 FL
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO-3613 FL Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO-3722 FL
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

7117 Congdon Rd Apt 200
Fort Myers, FL 33908-5004

Mailing address

7117 Congdon Rd Apt 200
Fort Myers, FL 33908-5004
Phone (239) 936-5400

Other practice location 1

1617 Santa Barbara Blvd
Cape Coral, FL 33991-3445
Phone (239) 458-5775

Other practice location 2

9240 Bonita Beach Rd SE
Bonita Springs, FL 34135-4249
Phone (239) 947-2112

Other identifiers 2

IdentifierTypeStateIssuer
CN1511OtherFLRAILROAD MEDICARE
340184700MedicaidFL

Other names 1

  • FOOT & ANKLE GROUP Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051108000353 FL Part B Supplier - Clinic/Group Practice 1951329986 Receives reassigned benefits from 4 practitioners
Practice locations: Bonita Springs, FL; Fort Myers, FL; Cape Coral, FL
O20100930045831 FL DME Supplier - Physician - Podiatry 1951329986 Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

9240 Bonita Beach Rd SE
Bonita Springs, FL 34135
Phone (239) 947-2112

9240 Bonita Beach Rd SE
Ste 1100
Bonita Springs, FL 34135
Phone (239) 947-2112

1510 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 422-6031

1510 Santa Barbara Blvd
Ste A
Cape Coral, FL 33991
Phone (239) 458-5775

1617 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 458-5775

7117 Congdon Rd
Apt 200
Fort Myers, FL 33908
Phone (239) 936-5400

7117 Congdon Rd
Fort Myers, FL 33908

260 Beth Stacey Blvd
Unit 140
Lehigh Acres, FL 33936
Phone (239) 369-5342

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1194725002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 CONGDON RD APT 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085004",
            "telephone_number": "239-936-5400",
            "fax_number": "239-936-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 CONGDON RD APT 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085004",
            "telephone_number": "239-936-5400",
            "fax_number": "239-936-9572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1617 Santa Barbara Blvd",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339913445",
            "country_code": "US",
            "telephone_number": "239-458-5775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9240 Bonita Beach Rd SE",
            "address_purpose": "LOCATION",
            "city": "Bonita Springs",
            "state": "FL",
            "postal_code": "341354249",
            "country_code": "US",
            "telephone_number": "239-947-2112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOT & ANKLE GROUP OF SOUTHWEST FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEROLD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "239-936-5400"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO-1326",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO-2020",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO-1693",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO-3613",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO-3722",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN1511",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340184700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOT & ANKLE GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.