NPIMap

Organization Active NPI

Podiatry Associates of Florida Inc

  • Podiatrist
  • Lake City, FL
National Provider Identifier
1376644732
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PODIATRY ASSOCIATES OF FLORIDA INC
Practice address
1384 S.E. Baya Dr.
Ste 150
Lake City, FL 32025-4888
Phone
(904) 224-2001
Fax
(904) 224-2002
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Susan G Sinchuk
Title
Corporate Administrator
Phone
(904) 224-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1384 S.E. Baya Dr.
Ste 150
Lake City, FL 32025-4888

Mailing address

3117 Spring Glen Rd
Ste 402
Jacksonville, FL 32207-5906
Phone (904) 224-2001

Other names 1

  • Podiatry Associates of Northeast Florida Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050324000347 FL Part B Supplier - Clinic/Group Practice 8820044688 Receives reassigned benefits from 16 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Orange Park, FL; Jacksonville Beach, FL; Clearwater, FL

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

3117 Spring Glen Rd
Ste 402
Jacksonville, FL 32207
Phone (800) 341-5024

1384 SE Baya Dr
Ste 150
Lake City, FL 32025

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1376644732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 SPRING GLEN RD",
            "address_2": "STE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075906",
            "telephone_number": "904-224-2001",
            "fax_number": "904-224-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 S.E. BAYA DR.",
            "address_2": "STE 150",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320254888",
            "telephone_number": "904-224-2001",
            "fax_number": "904-224-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "SINCHUK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CORPORATE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-224-2001"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Podiatry Associates of Northeast Florida Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.