Individual provider Active NPI

Michael J Cosimeno, DPM

  • Podiatrist
  • Round Rock, TX
National Provider Identifier
1619207321
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1994 Issued in TX
Practice address
7 Ridgemeadow Way
Round Rock, TX 78664-9614
Phone
(315) 525-6444
NPI assigned
Dec 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1994 TX Primary

Addresses

Primary practice location

7 Ridgemeadow Way
Round Rock, TX 78664-9614

Mailing address

7 Ridgemeadow Way
Round Rock, TX 78664-9614
Phone (315) 525-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120302000574 TX Practitioner - Podiatry 3274792759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group PAGroup PAC ID 1759334782, 24 clinicians

Practice addresses (Care Compare)

2413 E Loop 820
Fort Worth, TX 76118-6933
Phone (888) 964-6681

4201 Stonegate Blvd
Fort Worth, TX 76109-9503
Phone (888) 964-6681

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue4371
Removal or shaving of skin growth68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1994TXMDPodiatrist

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": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1619207321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RIDGEMEADOW WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786649614",
            "telephone_number": "315-525-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 RIDGEMEADOW WAY",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786649614",
            "telephone_number": "315-525-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSIMENO",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-31",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.