Individual provider Active NPI

Nitie I Sroa, D.P.M.

  • Podiatrist
  • Hicksville, OH
National Provider Identifier
1215236864
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3700 Issued in FL
Practice address
208 Columbus St Ste 200
Hicksville, OH 43526-1250
Phone
(419) 799-1180
NPI assigned
Mar 22, 2011
Last updated
May 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07001153A IN
Podiatrist 213E00000X 07001153B IN
Podiatrist 213E00000X POD001257 GA
Podiatrist 213E00000X PO3700 FL Primary
Foot Surgery Podiatrist 213ES0131X POD001257 GA

Addresses

Primary practice location

208 Columbus St Ste 200
Hicksville, OH 43526-1250

Mailing address

13611 Puff Rd
Fort Wayne, IN 46845-8802
Phone (419) 799-1180

Other identifiers 5

IdentifierTypeStateIssuer
07001153BOtherINPODIATRIC LICENSE
POD001257OtherGAPODIATRY LICENSE
36.003857OtherOHPODIATRIC LICENSE
PO3700OtherFLPODIATRIC FLORIDA LICENSE
07001153AOtherINPODIATRIC LICENSE

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
I20210721001124 OH Practitioner - Podiatry 8426291469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 Columbus St
Suite 200
Hicksville, OH 43526-1250
Phone (419) 799-1180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue254
Removal of skin lesions61
Removal of nail tissue107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001257GAMDPodiatrist
07001153AINMDPodiatrist
07001153BINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Foot and Ankle Clinic LLC Podiatrist CurrentSince Aug 2, 2021 Accepting new patients
Midwest Foot and Ankle Clinic LLC Podiatrist CurrentSince Jun 14, 2021 Accepting new patients
Midwest Foot and Ankle Clinic LLC Podiatrist Past Accepting new patients
Midwest Foot and Ankle Clinic LLC Podiatrist Past Accepting new patients
Midwest Foot and Ankle Clinic LLC Podiatrist Past Accepting new patients
Peach State Surgical Centers, Inc Podiatrist Past Accepting new patients

Locations

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

1200 Ralston Ave
Ste 402
Defiance, OH 43512
Phone (419) 799-1180

208 Columbus St
Ste 200
Hicksville, OH 43526
Phone (419) 799-1180

1600 E Riverview Ave
Ste 102
Napoleon, OH 43545
Phone (419) 251-3700

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIGECD/Endpoint/FIGECD
  • Direct secure messaging: nsroa119699@direct.parkviewexchange.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1215236864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13611 PUFF RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458802",
            "telephone_number": "419-799-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST STE 200",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-799-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROA",
        "first_name": "NITIE",
        "middle_name": "I",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001153A",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07001153B",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001257",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3700",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "GA",
            "license": "POD001257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRIC LICENSE",
            "identifier": "07001153B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY LICENSE",
            "identifier": "POD001257",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRIC LICENSE",
            "identifier": "36.003857",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRIC FLORIDA LICENSE",
            "identifier": "PO3700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRIC LICENSE",
            "identifier": "07001153A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, OH

Sources for this page

Verify at the official NPI Registry.