Individual provider Active NPI

Erica Faye Suprenant, DPM

  • Podiatrist
  • Dayton, OH
National Provider Identifier
1649699158
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003787 Issued in OH
Practice address
8721 N Main St
Dayton, OH 45415-1331
Phone
(937) 264-3150
Fax
(513) 858-7827
NPI assigned
Apr 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 36003787 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X NY

Addresses

Primary practice location

8721 N Main St
Dayton, OH 45415-1331

Mailing address

6200 Pleasant Ave Ste 3
Fairfield, OH 45014-4671
Phone (513) 829-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170523000767 OH Practitioner - Podiatry 3870860869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8721 N Main St
Dayton, OH 45415-1331
Phone (937) 264-3150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12
Removal of skin lesions1-10
Removal of nail tissue954
Removal or shaving of skin growth179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36003787OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Foot and Ankle Specialists of Ohio Inc Podiatrist CurrentSince Jun 1, 2017 Accepting new patients
Associated Foot and Ankle Specialists of Ohio Inc Podiatrist CurrentSince Jun 1, 2017 Accepting new patients

Locations

1001 Shroyer Rd
Dayton, OH 45419
Phone (855) 669-7843

1989 Miamisburg Centerville Rd
Ste 200
Dayton, OH 45459
Phone (937) 832-7691

8721 N Main St
Dayton, OH 45415
Phone (937) 223-7106

6200 Pleasant Ave
Ste 3
Fairfield, OH 45014
Phone (513) 745-9988

Interoperability endpoints

  • Direct secure messaging: ericasuprenant@afaso.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1649699158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PLEASANT AVE STE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144671",
            "telephone_number": "513-829-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8721 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151331",
            "telephone_number": "937-264-3150",
            "fax_number": "513-858-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPRENANT",
        "first_name": "ERICA",
        "middle_name": "FAYE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-11",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003787",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.