Organization Active NPI

Foot and Ankle Specialists of the Mid-Atlantic, LLC

  • Foot & Ankle Surgery Podiatrist
  • Raleigh, NC
National Provider Identifier
1457976334
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC
Practice address
1004 Dresser CT Ste 102
Raleigh, NC 27609-7325
Phone
(919) 872-2022
Fax
(919) 872-2087
NPI assigned
Jun 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Michael Tritto
Title
Managing Partner
Phone
(301) 933-7133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1004 Dresser CT Ste 102
Raleigh, NC 27609-7325

Mailing address

PO Box 844572
Boston, MA 02284-4572
Phone (301) 933-7133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171228000218 NC Part B Supplier - Clinic/Group Practice 6305017633 Receives reassigned benefits from 71 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dunn, NC; Gastonia, NC; Harrisburg, NC; Henderson, NC; Hendersonville, NC; Holly Springs, NC; Huntersville, NC; Lincolnton, NC…

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

717 S Torrence St
Charlotte, NC 28204
Phone (704) 334-8682

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1457976334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844572",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022844572",
            "telephone_number": "301-933-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 DRESSER CT STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097325",
            "telephone_number": "919-872-2022",
            "fax_number": "919-872-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "TRITTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "301-933-7133"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.