NPIMap

Organization Active NPI

Podiatric Medical Associates PC

  • Foot & Ankle Surgery Podiatrist
  • La Porte, IN
National Provider Identifier
1275926347
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PODIATRIC MEDICAL ASSOCIATES PC
Practice address
1501 State Street
La Porte, IN 46350-3115
Phone
(219) 362-5417
Fax
(219) 325-3431
NPI assigned
Mar 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Dr. Christopher S Grandfield, DPM
Title
Treasurer
Phone
(219) 362-5417

Specialties & licenses 1

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

Addresses

Primary practice location

1501 State Street
La Porte, IN 46350-3115

Mailing address

1501 State St
La Porte, IN 46350-3115
Phone (219) 362-5417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040112000205 IN Part B Supplier - Clinic/Group Practice 0941100283 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Porte, IN; Merrillville, IN; Portage, IN

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

1501 State St
Laporte, IN 46350
Phone (219) 362-5000

718 W 18th St
Laporte, IN 46350
Phone (219) 362-5417

303 W 89th Ave
Ste E1
Merrillville, IN 46410
Phone (219) 736-8915

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1275926347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 STATE ST",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503115",
            "telephone_number": "219-362-5417",
            "fax_number": "219-325-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 STATE STREET",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503115",
            "telephone_number": "219-362-5417",
            "fax_number": "219-325-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRIC MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "GRANDFIELD",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "219-362-5417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.