Individual provider Active NPI

Nathan D Sockrider, D.P.M.

  • Podiatrist
  • Racine, WI
National Provider Identifier
1285894055
Registry record updated Jun 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
926025 Issued in WI
Practice address
3500 Meachem Rd
Racine, WI 53405-4681
Phone
(262) 554-7004
Fax
(262) 554-7833
NPI assigned
Jun 14, 2008
Last updated
Jun 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 926025 WI Primary

Addresses

Primary practice location

3500 Meachem Rd
Racine, WI 53405-4681

Mailing address

145 N Jackson St
Apt 511
Milwaukee, WI 53202-6126
Phone (262) 554-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20080821000538 WI Practitioner - Podiatry 3072688209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 928-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue20
Removal of skin lesions1-10
Removal of nail tissue47
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
926025WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jul 9, 2018 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jul 9, 2018 Accepting new patients
Horizon Home Care & Hospice, Inc. Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

2130 Big Bend Rd
Waukesha, WI 53189
Phone (262) 928-7555

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: nsockrider79715@direct.phci.org

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213401600000",
    "number": "1285894055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N JACKSON ST",
            "address_2": "APT 511",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532026126",
            "telephone_number": "262-554-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 MEACHEM RD",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054681",
            "telephone_number": "262-554-7004",
            "fax_number": "262-554-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCKRIDER",
        "first_name": "NATHAN",
        "middle_name": "D",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-14",
        "last_updated": "2008-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "926025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.