Maricopa Podiatry Corporation

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

0599 Issued in AZ

Legal business name

MARICOPA PODIATRY CORPORATION

Practice address

12361 W Bola Dr
Suite 100
Surprise, AZ 85378-9021

Phone

(623) 214-3335

Fax

(623) 214-3956

NPI assigned

Jan 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Tharesh Udupa, DPM

Title

Owner

Phone

(623) 214-3335

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1649456229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9350",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853740139",
            "telephone_number": "623-214-3335",
            "fax_number": "623-214-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR",
            "address_2": "SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-214-3335",
            "fax_number": "623-214-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA PODIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "UDUPA",
        "authorized_official_first_name": "THARESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-214-3335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AZ",
            "license": "0599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842171",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Dennis Marco, PHARMD
• Eric Daniel Marcotte, D.C.
• Carrie Mardula, LPC
• Marhaba Home Care LLC
• Michael Mariano Nabong, MD
• Paulina Elise Mariki-Mhango, MD
• Maria Alexandra Marinca, MSN FNP
• Lauree J Marino, RN
• Micaela Marie Marks
• Molly Marks

• Foot Surgery Podiatrist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Foot Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.