Organization Active NPI

Robert Paul Dunne DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Melbourne, FL
National Provider Identifier
1639328396
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2287 Issued in FL
Legal business name
ROBERT PAUL DUNNE DPM PA
Practice address
2717 N. Wickham Rd
Suite 4
Melbourne, FL 32935
Phone
(321) 253-6191
Fax
(321) 253-6194
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Anna McElrath
Title
Office Manager
Phone
(321) 253-6191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO2287 FL Primary

Addresses

Primary practice location

2717 N. Wickham Rd
Suite 4
Melbourne, FL 32935

Mailing address

2717 N. Wickham Rd
Suite 4
Melbourne, FL 32935
Phone (321) 253-6191

Other names 1

  • Lake Washington Foot and Ankle Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930002598 FL DME Supplier - Physician - PodiatryDME Supplier - Orthotic Personnel 6507986296 Practice locations: Melbourne, FL
O20101015001135 FL Part B Supplier - Clinic/Group Practice 6507986296 Receives reassigned benefits from 1 practitioner
Practice locations: Melbourne, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2014981Lake Washington Foot & Ankle2717 N Wickham Road Suite 4, Melbourne, FL 32935Provider-performed microscopyMar 10, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Robert Paul Dunne DPM PA2717 N Wickham Rd, Melbourne, FL 32935-2200(321) 253-6191 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

2717 N Wickham Rd
Ste 4
Melbourne, FL 32935
Phone (321) 253-6191

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1639328396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 N. WICKHAM RD",
            "address_2": "SUITE 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-253-6191",
            "fax_number": "321-253-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 N. WICKHAM RD",
            "address_2": "SUITE 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32935",
            "telephone_number": "321-253-6191",
            "fax_number": "321-253-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT PAUL DUNNE DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "MCELRATH",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-253-6191"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Washington Foot and Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.