NPIMap

Organization Active NPI

Foot & Ankle Center, LLC

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1366408205
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000806 Issued in MO
Legal business name
FOOT & ANKLE CENTER, LLC
Practice address
1299 Reavis Barracks Rd
Saint Louis, MO 63125-3260
Phone
(314) 487-9300
Fax
(314) 487-0120
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Louis Aquino, DPMNPI 1417944653
Title
Authorized Official
Phone
(314) 487-9300

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 0000481 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016003754 IL
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 000806 MO Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016004898 IL
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 2004019390 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016005263 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 2001012399 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 000540 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 016004166 IL

Addresses

Primary practice location

1299 Reavis Barracks Rd
Saint Louis, MO 63125-3260

Mailing address

1299 Reavis Barracks Rd
Saint Louis, MO 63125-3260
Phone (314) 487-9300

Other identifiers 9

IdentifierTypeStateIssuer
4461710007OtherILMEDICARE DMERC GC
4461710005OtherMOMEDICARE DMERC LSTL
4461710002OtherMODMERC MO BAP
4461710010OtherILMEDICARE DMERC PINCKNEY
4461710008OtherILMEDICARE DMERC FH
4461710009OtherILMEDICARE DMERC WATERLOO
4461710003OtherMODMERC ST CHARLES
4461710004OtherMOMEDICARE DMERC N COUNTY
4461710006OtherMOMEDICARE DMERC SUNSET HIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040804001587 MO Part B Supplier - Clinic/Group Practice 9032180757 Receives reassigned benefits from 6 practitioners
5 other NPIs on this enrollment
Practice locations: Saint Charles, MO; Saint Louis, MO
O20060301000201 IL Part B Supplier - Clinic/Group Practice 9032180757 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Fairview Heights, IL; Waterloo, IL; Pinckneyville, IL; Maryville, IL; Granite City, IL
O20100930061237 MO DME Supplier - Physician - Podiatry 9032180757 Practice locations: Saint Louis, MO

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Foot and Ankle Center LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5400 N Illinois St
Ste 104
Fairview Heights, IL 62208
Phone (618) 235-1500

7345 Watson Rd
Ste 101
Saint Louis, MO 63119
Phone (314) 487-9300

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1366408205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 REAVIS BARRACKS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253260",
            "telephone_number": "314-487-9300",
            "fax_number": "314-487-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 REAVIS BARRACKS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253260",
            "telephone_number": "314-487-9300",
            "fax_number": "314-487-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "314-487-9300",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "0000481",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016003754",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000806",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004898",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2004019390",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "016005263",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2001012399",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000540",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004166",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC GC",
            "identifier": "4461710007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC LSTL",
            "identifier": "4461710005",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC MO BAP",
            "identifier": "4461710002",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC PINCKNEY",
            "identifier": "4461710010",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC FH",
            "identifier": "4461710008",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC WATERLOO",
            "identifier": "4461710009",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC ST CHARLES",
            "identifier": "4461710003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC N COUNTY",
            "identifier": "4461710004",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC SUNSET HIL",
            "identifier": "4461710006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.