Organization Active NPI

Maysville Foot & Ankle Clinic

  • Podiatrist
  • Maysville, KY
National Provider Identifier
1285713370
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00213
Legal business name
MAYSVILLE FOOT & ANKLE CLINIC
Practice address
2011 Old Main St
Maysville, KY 41056
Phone
(606) 759-5686
Fax
(606) 759-0368
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Authorized official

Name
Dr. Marc D Pawsat, DPMNPI 1538241989
Title
President
Phone
(606) 759-5686

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 00213 Primary

Addresses

Primary practice location

2011 Old Main St
Maysville, KY 41056

Mailing address

2011 Old Main St
Maysville, KY 41056
Phone (606) 759-5686

Other identifiers 1

IdentifierTypeStateIssuer
90110818MedicaidKY

Other names 1

  • Marc D Pawsat DPM Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930079096 KY DME Supplier - Physician - Podiatry 5294847554 Practice locations: Maysville, KY
O20110328000013 KY Part B Supplier - Other Medical Care Group 5294847554 Receives reassigned benefits from 1 practitioner
Practice locations: Flemingsburg, KY; Maysville, KY

National Provider Directory

National Provider Directory
Tax ID family
Marc D Pawsat DPM2 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

2011 Old Main St
Maysville, KY 41056
Phone (606) 759-5686

Practitioners & affiliated clinicians

Practitioners 1

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1285713370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 OLD MAIN ST",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "41056",
            "telephone_number": "606-759-5686",
            "fax_number": "606-759-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 OLD MAIN ST",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "41056",
            "telephone_number": "606-759-5686",
            "fax_number": "606-759-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYSVILLE FOOT & ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "PAWSAT",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-759-5686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": "00213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90110818",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc D Pawsat DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.