Active Foot & Ankle Associates PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ACTIVE FOOT & ANKLE ASSOCIATES PC

Practice address

3935 W 26TH St
Chicago, IL 60623-3706

Phone

(773) 762-2000

Fax

(773) 762-3350

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Barry W Minerof, DPMNPI 1548385768

Title

Owner

Phone

(773) 762-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Barry W Minerof, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1548385768
  Medicare reassignment NPD Authorized official
• Charles T Allen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1144345364
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1578688701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3935 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233706",
            "telephone_number": "773-762-2000",
            "fax_number": "773-762-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233706",
            "telephone_number": "773-762-2000",
            "fax_number": "773-762-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE FOOT & ANKLE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "MINEROF",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-762-2000",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60010797",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.