Individual provider Active NPI

Claude I Mayembe Sr., DPM

  • Podiatrist
  • Suwanee, GA
National Provider Identifier
1306153838
Registry record updated Jul 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001203 Issued in GA
Practice address
3245 Peachtree Pkwy Ste D-475
Suwanee, GA 30024-6054
Phone
(678) 288-9205
Fax
(678) 926-3550
NPI assigned
Sep 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001203 GA Primary

Addresses

Primary practice location

3245 Peachtree Pkwy Ste D-475
Suwanee, GA 30024-6054

Mailing address

3245 Peachtree Pkwy Ste D-475
Suwanee, GA 30024-6054
Phone (678) 288-9205

Other identifiers 1

IdentifierTypeStateIssuer
003129593MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20121107000271 GA Practitioner - Podiatry 3678752425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4950 Gladstone Pkwy
Suwanee, GA 30024-6945
Phone (678) 288-9205

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue97
Removal or shaving of skin growth60
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001203GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stride Foot & Ankle Center, LLC Podiatrist CurrentSince Jul 27, 2018 Accepting new patients
Alex S. Katz DPM, LLC Past Accepting new patients
Absolute Footcare PC Podiatrist PastSince Sep 4, 2011 Accepting new patients

Locations

4775 Jimmy Carter Blvd
Ste 101
Norcross, GA 30093
Phone (678) 694-8407

3245 Peachtree Pkwy
Ste D475
Suwanee, GA 30024
Phone (678) 288-9205

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.

NPI Registry JSON

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532736000000",
    "number": "1306153838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 PEACHTREE PKWY STE D-475",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246054",
            "telephone_number": "678-288-9205",
            "fax_number": "678-926-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 PEACHTREE PKWY STE D-475",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246054",
            "telephone_number": "678-288-9205",
            "fax_number": "678-926-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYEMBE",
        "first_name": "CLAUDE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2018-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003129593",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.