Organization Active NPI

Barry University

Doing business as Barry University Foot and Ankle Institute

  • Foot & Ankle Surgery Podiatrist
  • Miami, FL
National Provider Identifier
1194905703
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BARRY UNIVERSITY
Doing business as
Barry University Foot and Ankle Institute
Practice address
1190 NW 95TH St
Suite 102
Miami, FL 33150-2063
Phone
(305) 691-1787
Fax
(305) 691-5337
NPI assigned
Nov 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Authorized official

Name
John Nelson, DPM
Title
Associate Dean of Clinics
Phone
(305) 899-3252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1190 NW 95TH St
Suite 102
Miami, FL 33150-2063

Mailing address

11300 NE 2ND Ave
Pod
Miami Shores, FL 33161-6628
Phone (305) 899-4061

Other identifiers 1

IdentifierTypeStateIssuer
029648100MedicaidFL

Other names 1

  • Barry University Foot and Ankle Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000902 FL Part B Supplier - Clinic/Group Practice 3870499718 Receives reassigned benefits from 17 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami Beach, FL; Tamarac, FL; North Miami Beach, FL; Miami, FL; Hialeah, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1190 NW 95th St
Ste 102
Miami, FL 33150
Phone (305) 691-1787

Practitioners & affiliated clinicians

Practitioners 1

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": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1194905703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 NE 2ND AVE",
            "address_2": "POD",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331616628",
            "telephone_number": "305-899-4061",
            "fax_number": "305-899-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 NW 95TH ST",
            "address_2": "SUITE 102",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331502063",
            "telephone_number": "305-691-1787",
            "fax_number": "305-691-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ASSOCIATE DEAN OF CLINICS",
        "authorized_official_telephone_number": "305-899-3252",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029648100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barry University Foot and Ankle Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.