Anna Marie Chwastiak, D.P.M.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO 3582 Issued in PA

Practice address

3651 Lake Center Dr.
Mount Dora, FL 32757

Phone

(352) 385-9156

NPI assigned

Nov 16, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Janet L Black D P M P a

  • Primary Podiatric Medicine Podiatrist
  • Mount Dora, FL
  • NPI 1891844270
  NPD (past)
• Yhn 1, LLC

  • Podiatrist
  • Mount Dora, FL
  • NPI 1174212625
  NPD (past)

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1669716478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27650 SE HIGHWAY 42",
            "city": "UMATILLA",
            "state": "FL",
            "postal_code": "32784",
            "telephone_number": "410-241-3320",
            "fax_number": "352-669-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 LAKE CENTER DR.",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "32757",
            "telephone_number": "352-385-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHWASTIAK",
        "first_name": "ANNA MARIE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "PO 3582",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC-004063-L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirolab 360 Sport & Spine PLLC
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• Corian Ashlee Christofaro
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• Eric Harry Coe, MD
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• Alan Mitchell Cohen, M.D.
• Michael Cohen

• Foot Surgery Podiatrist in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Foot Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.