NPIMap

Organization Active NPI

Integrated Foot and Ankle Specialists of PA LLC

  • Podiatric Clinic/Center
  • Wyomissing, PA
National Provider Identifier
1508622689
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC
Practice address
50 Berkshire CT Ste 1
Wyomissing, PA 19610-1219
Phone
(610) 373-4154
NPI assigned
Feb 26, 2024
Organization subpart
Yes
Parent organization
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Teresa Leonarda Ciaccio
Title
Chief Operating Officer
Phone
(516) 993-8666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

50 Berkshire CT Ste 1
Wyomissing, PA 19610-1219

Mailing address

50 S 16TH St FL 17
Philadelphia, PA 19102-3530

Other names 1

  • Berkshire Podiatry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250327000666 PA DME Supplier - Physician - General Practice 1153704754 Practice locations: Wyomissing, PA

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Integrated Foot and Ankle Specialists of PA LLC

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1508622689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S 16TH ST FL 17",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BERKSHIRE CT STE 1",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101219",
            "telephone_number": "610-373-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "CIACCIO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LEONARDA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "516-993-8666"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berkshire Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.