NPIMap

Organization Active NPI

Podiatric Physicians of Arizona, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Mesa, AZ
National Provider Identifier
1194944728
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PODIATRIC PHYSICIANS OF ARIZONA, INC.
Practice address
1620 S Stapley Dr
132
Mesa, AZ 85204-6634
Phone
(480) 834-8804
Fax
(480) 464-8287
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Ashley Koch
Title
Cfo
Phone
(617) 562-7070

Specialties & licenses 1

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

Addresses

Primary practice location

1620 S Stapley Dr
132
Mesa, AZ 85204-6634

Mailing address

PO Box 847818
Dallas, TX 75284-7818
Phone (480) 834-8804

Other identifiers 2

IdentifierTypeStateIssuer
CD4380OtherAZPALMETTO GBA, RAILROAD MEDICARE
500144MedicaidAZ

Other names 1

  • Arizona Institute of Footcare Physicians Doing business as

National Provider Directory

National Provider Directory

Locations

11851 N 51st Ave
Ste 132
Glendale, AZ 85304

1640 S Stapley Dr
Mesa, AZ 85204

1620 S Stapley Dr
Mesa, AZ 85204

525 N 18th St
Ste 404
Phoenix, AZ 85006
Phone (602) 264-7273

2122 E Highland Ave
Phoenix, AZ 85016

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1194944728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847818",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847818",
            "telephone_number": "480-834-8804",
            "fax_number": "480-464-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S STAPLEY DR",
            "address_2": "132",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046634",
            "telephone_number": "480-834-8804",
            "fax_number": "480-464-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRIC PHYSICIANS OF ARIZONA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-562-7070"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA, RAILROAD MEDICARE",
            "identifier": "CD4380",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500144",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Institute of Footcare Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arizona Institute of Footcare Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.