NPIMap

Organization Active NPI

Podiatry Associates of Florida Inc

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1679777668
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO-01121 Issued in FL
Legal business name
PODIATRY ASSOCIATES OF FLORIDA INC
Practice address
320 Dundas Dr
Ste 7-8
Jacksonville, FL 32218-8502
Phone
(904) 757-4523
Fax
(904) 726-9987
NPI assigned
Jun 13, 2007
Last updated
Sep 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Susan G Sinchuk
Title
Corporate Administrator
Phone
(904) 224-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO-01121 FL Primary

Addresses

Primary practice location

320 Dundas Dr
Ste 7-8
Jacksonville, FL 32218-8502

Mailing address

3117 Spring Glen Rd
Ste 402
Jacksonville, FL 32207-5906
Phone (904) 224-2001

Other identifiers 6

IdentifierTypeStateIssuer
P00008626OtherRAILROAD MEDICARE
CI4974OtherRAILROAD MEDICARE
DA0704OtherRAILROAD MEDICARE
48002574OtherRAILROAD MEDICARE
65770OtherBLUE CROSS BLUE SHIELD
87606OtherBLUE CROSS BLUE SHIELD

Other names 1

  • Podiatry Associates of Northeast Florida Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050324000347 FL Part B Supplier - Clinic/Group Practice 8820044688 Receives reassigned benefits from 16 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Orange Park, FL; Jacksonville Beach, FL; Clearwater, FL

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

320 Dundas Dr
Ste 78
Jacksonville, FL 32218
Phone (904) 757-4523

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1679777668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 SPRING GLEN RD",
            "address_2": "STE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075906",
            "telephone_number": "904-224-2001",
            "fax_number": "904-224-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DUNDAS DR",
            "address_2": "STE 7-8",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188502",
            "telephone_number": "904-757-4523",
            "fax_number": "904-726-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "SINCHUK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CORPORATE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-224-2001"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO-01121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00008626",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI4974",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0704",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "48002574",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Podiatry Associates of Northeast Florida Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.