Individual provider Active NPI

Steven M Gillespie, DPM

  • Foot & Ankle Surgery Podiatrist
  • Green Valley, AZ
National Provider Identifier
1669814281
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0828 Issued in AZ
Practice address
1055 N la Canada Dr Ste 135
Green Valley, AZ 85614-3700
Phone
(520) 640-7010
Fax
(520) 640-7011
NPI assigned
Jul 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0828 AZ Primary

Addresses

Primary practice location

1055 N la Canada Dr Ste 135
Green Valley, AZ 85614-3700

Mailing address

1055 N la Canada Dr Ste 135
Green Valley, AZ 85614-3700
Phone (520) 640-7010

Other identifiers 1

IdentifierTypeStateIssuer
136228MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160428001417 AZ Practitioner - Podiatry 7911206784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1055 N la Canada Dr
Suite 135
Green Valley, AZ 85614-3700
Phone (520) 640-7010

Hospital & facility affiliations

  • Northwest Medical Center Sahuarita Hospital, Sahuarita, AZ, CCN 030148

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue218
Removal of skin lesions12
Removal of nail tissue1866
Removal or shaving of skin growth793
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Arizona Podiatry LLC Foot & Ankle Surgery CurrentSince Jan 23, 2024 Accepting new patients
Barton S. Fink DPM LLC Foot & Ankle Surgery PastSince Jun 1, 2022 Accepting new patients
Oasis Dermatology PC PastSince Jul 5, 2020 Accepting new patients

Locations

1055 N La Canada Dr
Ste 135
Green Valley, AZ 85614
Phone (520) 399-4570

Organizations & group practices 3

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.

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": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1669814281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N LA CANADA DR STE 135",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856143700",
            "telephone_number": "520-640-7010",
            "fax_number": "520-640-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N LA CANADA DR STE 135",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856143700",
            "telephone_number": "520-640-7010",
            "fax_number": "520-640-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136228",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

Verify at the official NPI Registry.