Organization Active NPI

Highland Podiatry Associates Inc

  • Foot & Ankle Surgery Podiatrist
  • Highland HTS, OH
National Provider Identifier
1487836847
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36001699C Issued in OH
Legal business name
HIGHLAND PODIATRY ASSOCIATES INC
Practice address
850 Brainard Rd
Highland HTS, OH 44143-3146
Phone
(440) 473-0550
Fax
(440) 473-1266
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Authorized official

Name
Dr. Daniel J Cavolo, DPM
Title
Tax Id Owner
Phone
(440) 473-0550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 36001699C OH Primary

Addresses

Primary practice location

850 Brainard Rd
Highland HTS, OH 44143-3146

Mailing address

850 Brainard Rd
Highland HTS, OH 44143-3146
Phone (440) 473-0550

Other identifiers 3

IdentifierTypeStateIssuer
000000166644OtherOHANTHEM
0305959MedicaidOH
3206958OtherOHAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203000024 OH Part B Supplier - Clinic/Group Practice 0446447478 Receives reassigned benefits from 1 practitioner
Practice locations: Westlake, OH; Warrensville Heights, OH; Sagamore Hills, OH; Richmond HTS, OH; Mayfield HTS, OH; Highland HTS, OH; Cleveland, OH; Beachwood, OH

National Provider Directory

National Provider Directory

Locations

850 Brainard Rd
Ste 1
Cleveland, OH 44143

Practitioners & affiliated clinicians

Practitioners 3

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": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1487836847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BRAINARD RD",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441433146",
            "telephone_number": "440-473-0550",
            "fax_number": "440-473-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BRAINARD RD",
            "city": "HIGHLAND HTS",
            "state": "OH",
            "postal_code": "441433146",
            "telephone_number": "440-473-0550",
            "fax_number": "440-473-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PODIATRY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "CAVOLO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "TAX ID OWNER",
        "authorized_official_telephone_number": "440-473-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36001699C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000166644",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0305959",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3206958",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.