NPIMap

Organization Active NPI

Odro, Fazekas & Werd PA

Doing business as Foot and Ankle Associates

  • Podiatrist
  • Lakeland, FL
National Provider Identifier
1417132952
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO0000788 Issued in FL
Legal business name
ODRO, FAZEKAS & WERD PA
Doing business as
Foot and Ankle Associates
Practice address
2939 S Florida Ave
Lakeland, FL 33803-4046
Phone
(863) 687-3404
Fax
(863) 687-4672
NPI assigned
Jan 3, 2008
Last updated
Oct 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Authorized official

Name
Dr. Edward A Fazekas, DPM
Title
President
Phone
(863) 687-3404

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO0001370 FL
Podiatrist 213E00000X PO000248 FL
Podiatrist 213E00000X PO0000788 FL Primary

Addresses

Primary practice location

2939 S Florida Ave
Lakeland, FL 33803-4046

Mailing address

2939 S Florida Ave
Lakeland, FL 33803-4046
Phone (863) 687-3404

Other names 1

  • Foot and Ankle Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930080317 FL DME Supplier - Physician - Podiatry 2567598196 Practice locations: Lakeland, FL

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1417132952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034046",
            "telephone_number": "863-687-3404",
            "fax_number": "863-687-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034046",
            "telephone_number": "863-687-3404",
            "fax_number": "863-687-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODRO, FAZEKAS & WERD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "FAZEKAS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-687-3404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO0001370",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO000248",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO0000788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.