Chester Howard Penn, D.P.M.
Individual provider Active NPI Podiatrist · Callahan, FL
NPI 1699007237 · NPPES record last updated Apr 4, 2011
Key facts
- NPI
- 1699007237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- PO 3421 (FL)
- Practice address
- 542067 US Highway 1
Callahan, FL 32011-8110 - Phone
- (904) 879-2552
- Fax
- (904) 879-6360
- NPI assigned
- Feb 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Friedman and Greenhut DPM PA
Practice addresses (Care Compare)
2561 Riverside Ave
Jacksonville, FL 32204-4722
Phone (904) 308-7909
Hospital & facility affiliations
- Concierge Home Care
- Ascension St Vincent'S Clay County
- Ascension St Vincent'S Southside
- Ascension St Vincent'S Riverside
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 748 |
| Removal of nail tissue | 103 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101028000591 | FL | Practitioner - Podiatry | 4880888353 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO 3421 | FL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Friedman & Greenhut DPM PA | Podiatrist | Current |
Accepting new patients |
| Friedman & Greenhut, DPM, PA | Past | Accepting new patients |
Locations
542067 US Highway 1
Callahan, FL 32011
Phone (904) 879-2552
2561 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7909
1670 St Vincents Way
Ofc 120
Middleburg, FL 32068
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO 3421 | FL | Yes |
Addresses
Primary practice location
542067 US Highway 1
Callahan, FL 32011-8110
Mailing address
PO Box 1578
Callahan, FL 32011-1578
Phone (904) 879-2552
Other providers in Callahan, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.