NPIMap

Organization Active NPI

Dr Jessica Taub Podiatry DPM LLC

  • Foot & Ankle Surgery Podiatrist
  • Stuart, FL
National Provider Identifier
1285248286
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
DR JESSICA TAUB PODIATRY DPM LLC
Practice address
3515 SE Willoughby Blvd
Stuart, FL 34994-5059
Phone
(772) 283-3800
Fax
(772) 283-7046
NPI assigned
Sep 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Jessica Taub, DPMNPI 1598115636
Title
Owner Provider
Phone
(772) 283-3800

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

3515 SE Willoughby Blvd
Stuart, FL 34994-5059

Mailing address

3515 SE Willoughby Blvd
Stuart, FL 34994-5059
Phone (772) 283-3800

Other practice location 1

1801 SE Hillmoor Dr Ste C-208
Port St Lucie, FL 34952-7574
Phone (772) 283-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200924001708 FL Part B Supplier - Clinic/Group Practice 6002235025 Receives reassigned benefits from 7 practitioners
Practice locations: Stuart, FL; Hobe Sound, FL; Port St Lucie, FL
O20201020000154 FL DME Supplier - Physician - Podiatry 6002235025 Practice locations: Stuart, FL

National Provider Directory

National Provider Directory
Tax ID family
Dr Jessica Taub Podiatry DPM LLC2 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

10975 SE Federal Hwy
Hobe Sound, FL 33455
Phone (772) 283-3800

1331 SE Port St Lucie Blvd
Ste 1
Port Saint Lucie, FL 34952

943 SE Central Pkwy
Stuart, FL 34994
Phone (772) 283-3800

3430 Worthington Blvd
Ste 202
Urbana, MD 21704
Phone (240) 699-0003

Practitioners 7

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": "1599436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1285248286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945059",
            "telephone_number": "772-283-3800",
            "fax_number": "772-283-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349945059",
            "telephone_number": "772-283-3800",
            "fax_number": "772-283-7046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 SE Hillmoor Dr Ste C-208",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349527574",
            "country_code": "US",
            "telephone_number": "772-283-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR JESSICA TAUB PODIATRY DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-07",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "TAUB",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "772-283-3800",
        "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 Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.