NPIMap

Organization Active NPI

Podiatrycare, PC

  • Foot & Ankle Surgery Podiatrist
  • Enfield, CT
National Provider Identifier
1396875365
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P00373 Issued in CT
Legal business name
PODIATRYCARE, PC
Practice address
1379 Enfield St
Enfield, CT 06082-5524
Phone
(860) 741-3041
Fax
(860) 741-5644
NPI assigned
Mar 7, 2007
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Dr. Robert Edward Marra, DPMNPI 1538139019
Title
President-Owner
Phone
(860) 741-3041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000303 CT
Foot & Ankle Surgery Podiatrist 213ES0103X P00373 CT Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 000731 CT

Addresses

Primary practice location

1379 Enfield St
Enfield, CT 06082-5524

Mailing address

1379 Enfield St
Enfield, CT 06082-5524
Phone (860) 741-3041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100301000015 CT Part B Supplier - Clinic/Group Practice 7719022987 Receives reassigned benefits from 4 practitioners
Practice locations: Enfield, CT; South Windsor, CT
O20100930063375 CT DME Supplier - Physician - Podiatry 7719022987 Practice locations: Enfield, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Podiatry Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1379 Enfield St
Enfield, CT 06082
Phone (860) 698-2981

1350 Sullivan Ave
South Windsor, CT 06074
Phone (860) 644-6525

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1396875365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825524",
            "telephone_number": "860-741-3041",
            "fax_number": "860-741-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825524",
            "telephone_number": "860-741-3041",
            "fax_number": "860-741-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRYCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "MARRA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "860-741-3041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000303",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "P00373",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CT",
            "license": "000731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.