NPIMap

Organization Active NPI

Lake Region Foot and Ankle LLC

  • Podiatrist
  • Windham, ME
National Provider Identifier
1467745901
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LAKE REGION FOOT AND ANKLE LLC
Practice address
5 Abby Rd
Windham, ME 04062
Phone
(207) 893-1989
Fax
(207) 893-0190
NPI assigned
May 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Melissa Milza, DPMNPI 1962669556
Title
Owner/President
Phone
(207) 893-1989

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5 Abby Rd
Windham, ME 04062

Mailing address

5 Abby Rd
Windham, ME 04062
Phone (207) 893-1989

Other names 1

  • Lake Region Foot & Ankle Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220629002782 ME Part B Supplier - Clinic/Group Practice 9638559206 Receives reassigned benefits from 2 practitioners
Practice locations: Windham, ME
O20230227000686 ME DME Supplier - Physician - Podiatry 9638559206 Practice locations: Windham, ME

National Provider Directory

National Provider Directory

Locations

5 Abby Rd
Windham, ME 04062
Phone (207) 893-1989

Practitioners & affiliated clinicians

Practitioners 8

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": "1305590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1467745901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ABBY RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "04062",
            "telephone_number": "207-893-1989",
            "fax_number": "207-893-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ABBY RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "04062",
            "telephone_number": "207-893-1989",
            "fax_number": "207-893-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-17",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "MILZA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "207-893-1989",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Region Foot & Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.