Organization Active NPI

Reliant Foot & Ankle Specialist PLLC

  • Foot & Ankle Surgery Podiatrist
  • Fort Worth, TX
National Provider Identifier
1669032934
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RELIANT FOOT & ANKLE SPECIALIST PLLC
Practice address
1650 W Rosedale St Ste 204
Fort Worth, TX 76104-7400
NPI assigned
Jun 18, 2019
Last updated
Jun 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Authorized official

Name
Michael Lam, DPMNPI 1346651387
Title
Owner
Phone
(214) 606-6895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X
Sports Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0000X
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1650 W Rosedale St Ste 204
Fort Worth, TX 76104-7400

Mailing address

7925 Caldelana Way
Fort Worth, TX 76131-3218
Phone (214) 606-6895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190723002604 TX Part B Supplier - Clinic/Group Practice 1355677766 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX
O20191007003017 TX DME Supplier - Physician - Podiatry 1355677766 Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1650 W Rosedale St
Ste 204
Fort Worth, TX 76104
Phone (817) 336-8773

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19919/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560816000000",
    "number": "1669032934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 CALDELANA WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761313218",
            "telephone_number": "214-606-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W ROSEDALE ST STE 204",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT FOOT & ANKLE SPECIALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A",
        "authorized_official_last_name": "LAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-606-6895",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.