Individual provider Active NPI

Larry J. Wapiennik, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Crown Point, IN
National Provider Identifier
1497806848
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07000451A Issued in IN
Practice address
11406 Broadway
Crown Point, IN 46307-7106
Phone
(219) 663-7737
Fax
(219) 663-7733
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 07000451A IN Primary

Addresses

Primary practice location

11406 Broadway
Crown Point, IN 46307-7106

Mailing address

11406 Broadway
Crown Point, IN 46307-7106
Phone (219) 663-7737

Other identifiers 5

IdentifierTypeStateIssuer
000000086346OtherINANTHEM
000000086347OtherINANTHEM
90001028OtherINBLUE CROSS BLUE SHIELD IL
8615234002OtherINCIGNA
480014055OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100527000481 IN Practitioner - Podiatry 0941339097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11406 Broadway
Crown Point, IN 46307-7106
Phone (219) 663-7737

Hospital & facility affiliations

  • Powers Health Rehabilitation Center Inpatient rehabilitation facility, Crown Point, IN, CCN 153045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue39
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Larry J. Wapiennik, DPM, PC Foot & Ankle Surgery CurrentSince Jul 8, 1980 Accepting new patients
Connecticut General Life Insurance Company Past Accepting new patients
Podiatric Management Systems LLC Foot & Ankle Surgery Past Accepting new patients

Locations

11406 Broadway
Crown Point, IN 46307
Phone (219) 663-7737

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1497806848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077106",
            "telephone_number": "219-663-7737",
            "fax_number": "219-663-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11406 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077106",
            "telephone_number": "219-663-7737",
            "fax_number": "219-663-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAPIENNIK",
        "first_name": "LARRY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000451A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000086346",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000086347",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "90001028",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8615234002",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480014055",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.