Modern Podiatry, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

MODERN PODIATRY, LLC

Practice address

255 W Lebanon Ste 202
Frisco, TX 75036-3411

Phone

(972) 645-7654

NPI assigned

Apr 30, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Woojung Michelle Lee, DPMNPI 1912352477

Title

Doctor/Founder

Phone

(972) 645-7654

Specialties & licenses 1

Addresses

Other names 1

• Modern Podiatry: Foot & Ankle Clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• Woojung Michelle Lee, DPM

  • Foot & Ankle Surgery Podiatrist
  • Frisco, TX
  • NPI 1912352477

  Single Specialty

  Medicare reassignment NPD Authorized official
• Katy Diane Brett, PA-C

  • Physician Assistant
  • Frisco, TX
  • NPI 1215644026
  NPD
• Victoria Herold, DO

  • Family Medicine Physician
  • Frisco, TX
  • NPI 1659785830

  Single Specialty

  NPD
• Samantha Jeanne Melillo, PA-C

  • Physician Assistant
  • Frisco, TX
  • NPI 1831823434
  NPD
• Anna Kristin Rusk, M.D.

  • Family Medicine Physician
  • Frisco, TX
  • NPI 1629431564
  NPD

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1629699798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5729 LEBANON RD STE 144328",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347260",
            "telephone_number": "972-645-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LEBANON STE 202",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750363411",
            "telephone_number": "972-645-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WOOJUNG",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DOCTOR/FOUNDER",
        "authorized_official_telephone_number": "972-645-7654",
        "authorized_official_name_prefix": "Dr.",
        "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": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lee@modpodiatry.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "255 W Lebanon Ste 202",
            "city": "Frisco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750363411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Modern Podiatry: Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Podiatry: Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richa Mittal, MD
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• Modera Clinic Gi, PLLC
• Modoma Medmassage, LLC
• Morgan Moffat
• Keri Mogus, LMT
• Salwa Abdu Mohamedaman
• Mohammad Zaim Nawaz MD PA

• Foot & Ankle Surgery Podiatrist in Frisco, TX
• Providers in Frisco, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.