Coastline Foot and Ankle Specialists LLC
Organization Active NPI Podiatrist · East Lyme, CT
NPI 1245938323 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1245938323
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- COASTLINE FOOT AND ANKLE SPECIALISTS LLC
- Practice address
- 131 Boston Post Rd
East Lyme, CT 06333-1605 - Phone
- (860) 739-1944
- Fax
- (860) 739-1974
- NPI assigned
- Feb 20, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Michal M Szpara, DPM
- Title
- Physician/Co-Founder
- Phone
- (203) 767-8478
Practitioners 4
-
Matthew W Lawrence, DPM
-
Michal Marcin Szpara, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230808001672 | CT | Part B Supplier - Clinic/Group Practice | 9739541731 |
Receives reassigned benefits from 4 practitioners Practice locations: East Lyme, CT |
| O20230810001678 | RI | Part B Supplier - Clinic/Group Practice | 9739541731 |
Receives reassigned benefits from 4 practitioners Practice locations: Westerly, RI |
National Provider Directory
Locations
131 Boston Post Rd
East Lyme, CT 06333
Phone (860) 691-1044
85 Beach St
#C
Westerly, RI 02891
Phone (401) 596-0823
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | Yes |
Addresses
Primary practice location
131 Boston Post Rd
East Lyme, CT 06333-1605
Mailing address
131 Boston Post Rd
East Lyme, CT 06333-1605
Phone (860) 739-1944
Other practice location 1
85 Beach St Bldg C
Westerly, RI 02891-2717
Phone (401) 596-0832
Other providers in East Lyme, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.