The Center for Foot and Ankle Surgery, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

000893 Issued in CT

Legal business name

THE CENTER FOR FOOT AND ANKLE SURGERY, LLC

Practice address

187 N Main St
Wallingford, CT 06492-3721

Phone

(203) 265-4814

Fax

(203) 949-4741

NPI assigned

Aug 7, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Michael Yardan, DPMNPI 1972866275

Title

President

Phone

(203) 265-4814

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 2

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

• Christopher Michael Yardan, DPM

  • Podiatrist
  • Wallingford, CT
  • NPI 1972866275
  Medicare reassignment NPD Authorized official
• John F D'Amico, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Wallingford, CT
  • NPI 1598704637
  NPD (past)

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1215313614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 N MAIN ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923721",
            "telephone_number": "203-265-4814",
            "fax_number": "203-949-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 N MAIN ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923721",
            "telephone_number": "203-265-4814",
            "fax_number": "203-949-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR FOOT AND ANKLE SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "YARDAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-265-4814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000893",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "000893",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12395920",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1972866275",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Taveras, DDS
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• The Young Men'S Christian Association of Wallingford, Incorporated

• Foot & Ankle Surgery Podiatrist in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Foot & Ankle Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.