Organization Active NPI

Segall Foot & Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Plantation, FL
National Provider Identifier
1366570913
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SEGALL FOOT & ANKLE INC
Practice address
201 NW 82ND Ave Ste 102
Plantation, FL 33324-1853
Phone
(954) 384-2555
Fax
(954) 900-5646
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Brigida Fenelon, CPC
Title
Office Manager
Phone
(954) 451-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

201 NW 82ND Ave Ste 102
Plantation, FL 33324-1853

Mailing address

201 NW 82ND Ave Ste 102
Plantation, FL 33324-1853
Phone (954) 384-2555

Other identifiers 1

IdentifierTypeStateIssuer
390064900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090709000231 FL Part B Supplier - Clinic/Group Practice 3971655721 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL
O20100930071302 FL DME Supplier - Physician - Podiatry 3971655721 Practice locations: Plantation, FL

National Provider Directory

National Provider Directory
Tax ID family
Segall Foot Ankle Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4800 N Federal Hwy
Fl 3
Ft Lauderdale, FL 33308
Phone (954) 434-3221

201 NW 82nd Ave
Ste 102
Plantation, FL 33324
Phone (954) 384-2555

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 1

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1366570913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW 82ND AVE STE 102",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241853",
            "telephone_number": "954-384-2555",
            "fax_number": "954-900-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NW 82ND AVE STE 102",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241853",
            "telephone_number": "954-384-2555",
            "fax_number": "954-900-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEGALL FOOT & ANKLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "FENELON",
        "authorized_official_first_name": "BRIGIDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "954-451-3010",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390064900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.