NPIMap

Organization Active NPI

Berks Foot and Ankle Surgical Associates, Inc

  • Foot & Ankle Surgery Podiatrist
  • Shillington, PA
National Provider Identifier
1245309319
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BERKS FOOT AND ANKLE SURGICAL ASSOCIATES, INC
Practice address
654 Philadelphia Ave
Shillington, PA 19607-2769
Phone
(610) 796-9522
Fax
(610) 796-0105
NPI assigned
Nov 6, 2006
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Kevin T Naugle, DPMNPI 1811978844
Title
President
Phone
(610) 796-9522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

654 Philadelphia Ave
Shillington, PA 19607-2769

Mailing address

654 Philadelphia Ave
Shillington, PA 19607-2769
Phone (610) 796-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040806000514 PA Part B Supplier - Clinic/Group Practice 8527030089 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Hamburg, PA; Shillington, PA
O20100930044644 PA DME Supplier - Physician - Podiatry 8527030089 Practice locations: Shillington, PA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Berks Foot Ankle Surg a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

260 State St
Hamburg, PA 19526
Phone (610) 562-3066

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 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1245309319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 PHILADELPHIA AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072769",
            "telephone_number": "610-796-9522",
            "fax_number": "610-796-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 PHILADELPHIA AVE",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196072769",
            "telephone_number": "610-796-9522",
            "fax_number": "610-796-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKS FOOT AND ANKLE SURGICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "NAUGLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-796-9522",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shillington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.