Individual provider Active NPI

Gary Michael Torkeo, D.P.M.

  • Podiatrist
  • Fort Wayne, IN
National Provider Identifier
1508867177
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07000628A Issued in IN
Practice address
4011 W Jefferson Blvd
Suite 175
Fort Wayne, IN 46804-6853
Phone
(260) 436-4438
Fax
(260) 432-2833
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07000628A IN Primary

Addresses

Primary practice location

4011 W Jefferson Blvd
Suite 175
Fort Wayne, IN 46804-6853

Mailing address

4011 W Jefferson Blvd
Suite 175
Fort Wayne, IN 46804-6853
Phone (260) 436-4438

Other identifiers 2

IdentifierTypeStateIssuer
480007130OtherINRAILROAD MEDICARE
100081320MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07000628AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Protailored Physical Therapy LLC PastSince Jun 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1508867177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 W JEFFERSON BLVD",
            "address_2": "SUITE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046853",
            "telephone_number": "260-436-4438",
            "fax_number": "260-432-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 W JEFFERSON BLVD",
            "address_2": "SUITE 175",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046853",
            "telephone_number": "260-436-4438",
            "fax_number": "260-432-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORKEO",
        "first_name": "GARY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000628A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480007130",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100081320",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.