Nicole Chwastiak, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

SC006565 Issued in PA

Practice address

617 E Broad St
Tamaqua, PA 18252-2206

Phone

(570) 668-5170

Fax

(570) 668-5171

NPI assigned

Aug 25, 2014

Last updated

Jun 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Richard Chwastiak, DPM

  • Podiatrist
  • Tamaqua, PA
  • NPI 1083615918
  Medicare reassignment
• Richard Chwastiak

  • Podiatrist
  • Tamaqua, PA
  • NPI 1205807815
  NPD (past)

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1649670803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182522206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182522206",
            "telephone_number": "570-668-5170",
            "fax_number": "570-668-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHWASTIAK",
        "first_name": "NICOLE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC006565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carbon - Schuylkill Community Hospital Inc (St. Luke's Miners Health Center Hometown)
• Care Link Home Care Services, LLC
• Cares Community and Residential Empowerment Services Inc
• Carroll Dental LLC
• Amber Marie Carroll, DMD
• Richard Chwastiak, DPM
• Commonwealth Emergency Services (Commonwealth EMS)
• Rachel Connely, MS, ATC, LAT
• Laura Josephine D'Amato, PA-C
• Douglas John Dennison, PT

• Foot Surgery Podiatrist in Tamaqua, PA
• Providers in Tamaqua, PA by specialty
• Foot Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.