Individual provider Active NPI

Ivan Dale McLaws, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Payson, AZ
National Provider Identifier
1356428536
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0252 Issued in AZ
Practice address
200 E Lone Pine St
Payson, AZ 85541-5519
Phone
(928) 474-9242
Fax
(928) 474-9241
NPI assigned
Nov 1, 2006
Last updated
Dec 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0252 AZ Primary

Addresses

Primary practice location

200 E Lone Pine St
Payson, AZ 85541-5519

Mailing address

PO Box 603
Payson, AZ 85547-0603
Phone (928) 474-9242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051024000009 AZ Practitioner - Podiatry 9436175023 Practice locations: Payson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 E Lone Pine Dr
Payson, AZ 85541-5519
Phone (928) 474-9242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue36
Removal of skin lesions1-10
Removal of nail tissue100
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1356428536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855470603",
            "telephone_number": "928-474-9242",
            "fax_number": "928-474-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E LONE PINE ST",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415519",
            "telephone_number": "928-474-9242",
            "fax_number": "928-474-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAWS",
        "first_name": "IVAN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

Verify at the official NPI Registry.