Individual provider Active NPI

Robert Terry Kirschenbaum, D.P.M.

  • Foot Surgery Podiatrist
  • Altamonte Springs, FL
National Provider Identifier
1366448235
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PO967 Issued in FL
Practice address
840 N State Road 434
Ste B
Altamonte Springs, FL 32714-7014
Phone
(407) 869-7077
Fax
(321) 777-8302
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X PO967 FL Primary

Addresses

Primary practice location

840 N State Road 434
Ste B
Altamonte Springs, FL 32714-7014

Mailing address

840 N State Road 434
Ste B
Altamonte Springs, FL 32714-7014
Phone (407) 869-7077

Other identifiers 3

IdentifierTypeStateIssuer
041256200MedicaidFL
0955000001OtherFLMEDICARE DMERC 2ND LOCAL
1366448235OtherFLMEDICARE DMERC

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
I20101229000098 FL Practitioner - Podiatry 1355464264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

840 N State Rd
434 Suite B
Altamonte Springs, FL 32714-7014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Removal of tissue28
Removal of skin lesions28
Removal of nail tissue177
Removal or shaving of skin growth62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Robert T Kirschenbaum, DPM, PA CurrentSince Dec 19, 1996 Accepting new patients
Affordable Foot Clinic PastSince Jun 1, 1990 Accepting new patients

Locations

840 N Sr 434
Ste B
Altamonte Springs, FL 32714
Phone (321) 600-4612

Organizations & group practices 2

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": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1366448235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N STATE ROAD 434",
            "address_2": "STE B",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147014",
            "telephone_number": "407-869-7077",
            "fax_number": "321-777-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N STATE ROAD 434",
            "address_2": "STE B",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147014",
            "telephone_number": "407-869-7077",
            "fax_number": "321-777-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHENBAUM",
        "first_name": "ROBERT",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041256200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC 2ND LOCAL",
            "identifier": "0955000001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "1366448235",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.