NPIMap

Organization Active NPI

Everett Foot Care PC

  • Podiatrist
  • Everett, MA
National Provider Identifier
1437128345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1857 Issued in MA
Legal business name
EVERETT FOOT CARE PC
Practice address
459 Broadway
Everett, MA 02149-3614
Phone
(617) 387-4200
Fax
(617) 387-8852
NPI assigned
Mar 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Anthony Medaglio, D.P.M.NPI 1922077908
Title
Owner
Phone
(617) 387-4200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 1857 MA Primary

Addresses

Primary practice location

459 Broadway
Everett, MA 02149-3614

Mailing address

459 Broadway
Everett, MA 02149-3614
Phone (617) 387-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060405000443 MA Part B Supplier - Clinic/Group Practice 2860400645 Receives reassigned benefits from 1 practitioner
Practice locations: Everett, MA

National Provider Directory

National Provider Directory

Locations

459 Broadway
Ste 200
Everett, MA 02149
Phone (617) 387-4200

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": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437128345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493614",
            "telephone_number": "617-387-4200",
            "fax_number": "617-387-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493614",
            "telephone_number": "617-387-4200",
            "fax_number": "617-387-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT FOOT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEDAGLIO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-387-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • 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.