Individual provider Active NPI

Andrew David Lonabaugh, DPM

  • Podiatrist
  • Stuart, FL
National Provider Identifier
1275965337
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3793 Issued in FL
Practice address
2291 SE Federal Hwy
Stuart, FL 34994-4516
Phone
(772) 286-9912
NPI assigned
Jul 31, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO3793 FL Primary

Addresses

Primary practice location

2291 SE Federal Hwy
Stuart, FL 34994-4516

Mailing address

2291 SE Federal Hwy
Stuart, FL 34994-4516
Phone (856) 904-1944

Other identifiers 1

IdentifierTypeStateIssuer
112063600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160624002087 FL Practitioner - Podiatry 6406147263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paul N Gotkin and David a Gubernick DPM PAGroup PAC ID 8820085905, 5 clinicians

Practice addresses (Care Compare)

2291 SE Federal Hwy
Stuart, FL 34994-4516
Phone (772) 286-9912

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Port Saint Lucie, FL, CCN 109270
  • HCA Florida Raulerson Hospital Hospital, Okeechobee, FL, CCN 100252
  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue205
Removal of skin lesions111
Removal of nail tissue125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3693FLMDPodiatrist
PO3793FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul N Gotkin & David a Gubernick DPM PA Single Specialty CurrentSince May 16, 2016 Accepting new patients
Paul N Gotkin, DPM & David a Gubernick, DPM PA Single Specialty CurrentSince May 16, 2016 Accepting new patients
Paul N Gotkin & David a Gubernick DPM PA Single Specialty Past Accepting new patients

Locations

1090 Virginia Ave
Fort Pierce, FL 34982
Phone (772) 461-2575

1095 NW Saint Lucie West Blvd
#222
Port St Lucie, FL 34986
Phone (772) 785-5580

2291 SE Federal Hwy
Stuart, FL 34994
Phone (772) 286-9912

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/-c6Xwd-UlrvkHnaNj_A8a39Pa03efHEX/

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1275965337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944516",
            "telephone_number": "856-904-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944516",
            "telephone_number": "772-286-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONABAUGH",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112063600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.