Easy Stride Pain & Injury Center, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC-001795-L Issued in PA

Legal business name

EASY STRIDE PAIN & INJURY CENTER, PC

Practice address

4014 Lancaster Ave # a
Philadelphia, PA 19104-1712

Phone

(215) 222-2225

Fax

(215) 222-3070

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. J Gregory Bancroft, D.P.M.

Title

Podiatrist

Phone

(215) 222-2225

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Bancroft, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
  • NPI 1073543559
  Medicare reassignment

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366591596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 LANCASTER AVE # A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041712",
            "telephone_number": "215-222-2225",
            "fax_number": "215-222-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LANCASTER AVE # A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041712",
            "telephone_number": "215-222-2225",
            "fax_number": "215-222-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASY STRIDE PAIN & INJURY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANCROFT",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "215-222-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC-001795-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1073543559",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500527",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY - EASY STR",
            "identifier": "1049959",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY INDIVIDUAL",
            "identifier": "31700",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE OF PA INDIVID",
            "identifier": "0050052704",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.