Individual provider Active NPI

Robert Edward Clemency III, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Schererville, IN
National Provider Identifier
1508127663
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07001211A Issued in IN
Practice address
1545 W US Highway 30
Schererville, IN 46375-1562
Phone
(219) 703-2440
Fax
(219) 703-6751
NPI assigned
Jun 6, 2012
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 07001211A IN Primary

Addresses

Primary practice location

1545 W US Highway 30
Schererville, IN 46375-1562

Mailing address

1545 W US Highway 30
Schererville, IN 46375-1562
Phone (219) 703-2440

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
I20150709002957 IN Practitioner - Podiatry 0345552998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Creighton University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

801 Macarthur Blvd
Suite 401
Munster, IN 46321-2919
Phone (219) 440-5290

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue890
Removal of nail tissue22
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001211AINMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince Mar 26, 2018 Accepting new patients
Munster Radiology Group PC PastSince Aug 23, 2020 Accepting new patients

Locations

801 MacArthur Blvd
Ste 401
Munster, IN 46321
Phone (219) 836-2860

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

1545 W US Highway 30
Schererville, IN 46375
Phone (219) 703-2440

Interoperability endpoints

  • Direct secure messaging: rclemency90168@ssdirect.comhs.org

Organizations & group practices 2

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

Hospital & facility affiliations 6

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1508127663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 W US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751562",
            "telephone_number": "219-703-2440",
            "fax_number": "219-703-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 W US HIGHWAY 30",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751562",
            "telephone_number": "219-703-2440",
            "fax_number": "219-703-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENCY",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001211A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

Verify at the official NPI Registry.