Individual provider Active NPI

Adam Jacob Siegel, DPM

  • Podiatrist
  • Lutz, FL
National Provider Identifier
1356690135
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3831 Issued in FL
Practice address
1005 Dale Mabry Hwy
Lutz, FL 33548-3021
Phone
(813) 549-5678
Fax
(813) 701-9132
NPI assigned
Sep 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X PO3831 FL
Sports Medicine Podiatrist 213ES0000X PO3831 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO3831 FL
Podiatrist 213E00000X PO3831 FL Primary
Foot Surgery Podiatrist 213ES0131X PO3831 FL

Addresses

Primary practice location

1005 Dale Mabry Hwy
Lutz, FL 33548-3021

Mailing address

15815 Shaddock Dr Ste 130
Winter Garden, FL 34787-5773
Phone (813) 400-1140

Other identifiers 5

IdentifierTypeStateIssuer
YED4QOtherBCBS
5409969OtherFLAETNA ID
1153305OtherFLCIGNA ID
13570457OtherCAQH ID
019362900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170720002192 FL Practitioner - Podiatry 1658684402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Podiatry Group Inc.Group PAC ID 0042252140, 42 clinicians

Practice addresses (Care Compare)

1005 Dale Mabry Hwy
Lutz, FL 33548-3021
Phone (813) 549-5678

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3831FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
All Podiatry Group Inc Podiatrist CurrentSince Jan 1, 2018 Accepting new patients
Evolve Health Texas PLLC Podiatrist PastSince Aug 1, 2025 Accepting new patients
Anne McNamara DPM PL Podiatrist Past Accepting new patients
Mfa Health Houston PLLC Podiatrist PastSince Jul 1, 2025 Accepting new patients

Locations

540 Medical Oaks Ave
Ste 101
Brandon, FL 33511
Phone (813) 681-3558

1005 Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 549-5678

2511 W Mlk Blvd
Tampa, FL 33607
Phone (813) 400-1140

15815 Shaddock Dr
Ste 130
Winter Garden, FL 34787
Phone (407) 605-2321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1356690135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15815 SHADDOCK DR STE 130",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875773",
            "telephone_number": "813-400-1140",
            "fax_number": "813-701-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 DALE MABRY HWY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335483021",
            "telephone_number": "813-549-5678",
            "fax_number": "813-701-9132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "ADAM",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO3831",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": "PO3831",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3831",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3831",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO3831",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "YED4Q",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "5409969",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ID",
            "identifier": "1153305",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "13570457",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019362900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.