Organization Active NPI

Jupiter Foot and Ankle PA

  • Podiatrist
  • Jupiter, FL
National Provider Identifier
1609981083
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO2828 Issued in FL
Legal business name
JUPITER FOOT AND ANKLE PA
Practice address
651 W Indiantown Road
Suite K
Jupiter, FL 33458
Phone
(561) 741-4900
Fax
(561) 741-4918
NPI assigned
Aug 19, 2006
Last updated
Oct 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Mr. Virginio Vena, DPMNPI 1831367465
Title
Owner President
Phone
(561) 741-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO2828 FL Primary

Addresses

Primary practice location

651 W Indiantown Road
Suite K
Jupiter, FL 33458

Mailing address

651 W Indiantown Road
Suite K
Jupiter, FL 33458
Phone (561) 741-4900

Other identifiers 1

IdentifierTypeStateIssuer
3402606-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930003829 FL DME Supplier - Physician - Podiatry 9032322102 Practice locations: Jupiter, FL
O20101105000623 FL Part B Supplier - Clinic/Group Practice 9032322102 Receives reassigned benefits from 1 practitioner
Practice locations: Jupiter, FL

National Provider Directory

National Provider Directory

Locations

651 W Indiantown Rd
Ste K
Jupiter, FL 33458
Phone (561) 741-4900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1609981083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W INDIANTOWN ROAD",
            "address_2": "SUITE K",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-741-4900",
            "fax_number": "561-741-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W INDIANTOWN ROAD",
            "address_2": "SUITE K",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-741-4900",
            "fax_number": "561-741-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER FOOT AND ANKLE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "VENA",
        "authorized_official_first_name": "VIRGINIO",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "561-741-4900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402606-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.