NPIMap

Organization Active NPI

Advanced Foot and Ankle Associates of Northwestern Pennsylvania PC

  • Foot & Ankle Surgery Podiatrist
  • Du Bois, PA
National Provider Identifier
1326469834
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC004334L Issued in PA
Legal business name
ADVANCED FOOT AND ANKLE ASSOCIATES OF NORTHWESTERN PENNSYLVANIA PC
Practice address
207 Beaver Dr
Du Bois, PA 15801-2517
Phone
(814) 371-0300
Fax
(814) 371-5000
NPI assigned
Dec 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Dr. Lara M Allman, DPMNPI 1477526283
Title
President
Phone
(814) 371-0300

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 SC004334L PA Primary

Addresses

Primary practice location

207 Beaver Dr
Du Bois, PA 15801-2517

Mailing address

207 Beaver Dr
Du Bois, PA 15801-2517
Phone (814) 371-0300

Other identifiers 2

IdentifierTypeStateIssuer
008549OtherPAMEDICARE PTAN
0017114190002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040727001317 PA Part B Supplier - Clinic/Group Practice 7214907328 Receives reassigned benefits from 1 practitioner
Practice locations: Du Bois, PA
O20140204000713 PA DME Supplier - Physician - Podiatry 7214907328 Practice locations: Du Bois, PA

National Provider Directory

National Provider Directory
Tax ID family
Advanced Foot and Ankle Associates of Northwestern Pennsylvania PC2 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.

Practitioners & affiliated clinicians

Practitioners 2

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": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1326469834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 BEAVER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012517",
            "telephone_number": "814-371-0300",
            "fax_number": "814-371-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 BEAVER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012517",
            "telephone_number": "814-371-0300",
            "fax_number": "814-371-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT AND ANKLE ASSOCIATES OF NORTHWESTERN PENNSYLVANIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "ALLMAN",
        "authorized_official_first_name": "LARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-371-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC004334L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "008549",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017114190002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.