Individual provider Active NPI

Frederick J Meccia, DPM

  • Podiatrist
  • Valparaiso, IN
National Provider Identifier
1639178718
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07000801 Issued in IN
Practice address
2002 Hendon Way
Valparaiso, IN 46385-8218
Phone
(219) 531-4917
NPI assigned
Jul 20, 2005
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016004365 IL
Podiatrist 213E00000X 07000801 IN Primary

Addresses

Primary practice location

2002 Hendon Way
Valparaiso, IN 46385-8218

Mailing address

2002 Hendon Way Ste 1a
Valparaiso, IN 46385-8218
Phone (800) 503-1375

Other identifiers 3

IdentifierTypeStateIssuer
0060001681OtherILBCBS OF ILLINOIS
000000227516OtherINANTHEM BCBS OF INDIANA
200045360AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040308000221 IN Practitioner - Podiatry 7012805534 Practice locations: Chesterton, IN; Warsaw, IN; Wakarusa, IN; Valparaiso, IN; Schererville, IN; Portage, IN; Mishawaka, IN; Merrillville, IN…

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 Beverly Dr
Chesterton, IN 46304-9368
Phone (219) 926-8387

2002 Hendon Way
Valparaiso, IN 46385-8218

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions21
Removal of nail tissue453
Removal or shaving of skin growth171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004365ILMDPodiatrist
07000801INMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Assisted Living Concepts Inc Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1639178718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 HENDON WAY STE 1A",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858218",
            "telephone_number": "800-503-1375",
            "fax_number": "866-681-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 HENDON WAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858218",
            "telephone_number": "219-531-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECCIA",
        "first_name": "FREDERICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004365",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0060001681",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF INDIANA",
            "identifier": "000000227516",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200045360A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.