Individual provider Active NPI

Barry L Efron, DPM

  • Foot & Ankle Surgery Podiatrist
  • Orange Park, FL
National Provider Identifier
1205823499
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO1160 Issued in FL
Practice address
2140 Kingsley Ave
Ste 12
Orange Park, FL 32073
Phone
(904) 272-7070
Fax
(904) 272-3668
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P00001160 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO1160 FL Primary

Addresses

Primary practice location

2140 Kingsley Ave
Ste 12
Orange Park, FL 32073

Mailing address

2140 Kingsley Ave Ste 12
Orange Park, FL 32073-5129
Phone (904) 272-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080404000286 FL Practitioner - Podiatry 5092817577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P00001160FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Medicine of North Florida LLC CurrentSince Dec 1, 2023 Accepting new patients
Old City Health CurrentSince Dec 1, 2023 Accepting new patients
Podiatry Associates of Florida, Inc. Podiatrist Past Accepting new patients

Locations

4540 Southside Blvd
Ste 401
Jacksonville, FL 32216
Phone (904) 566-9256

100 Whetstone Pl
Ste 208
St Augustine, FL 32086
Phone (904) 447-7377

Organizations & group practices 3

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1205823499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE STE 12",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735129",
            "telephone_number": "904-272-7070",
            "fax_number": "904-272-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "address_2": "STE 12",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-272-7070",
            "fax_number": "904-272-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EFRON",
        "first_name": "BARRY",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P00001160",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.