NPIMap

Organization Active NPI

Axel Podiatry Services LLC

  • Podiatrist
  • Fort Myers, FL
National Provider Identifier
1700339108
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
AXEL PODIATRY SERVICES LLC
Practice address
3050 Champion Ring Rd
Fort Myers, FL 33905-5599
Phone
(561) 869-3100
NPI assigned
Aug 2, 2016
Last updated
Dec 7, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
AXEL HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
Dr. Sumeet V Shetty, M DNPI 1245319391
Title
Owner
Phone
(239) 872-9734

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

3050 Champion Ring Rd
Fort Myers, FL 33905-5599

Mailing address

4820 Griffin Blvd
Fort Myers, FL 33908-2016
Phone (239) 313-2901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170225000156 FL Part B Supplier - Clinic/Group Practice 9436433182 Receives reassigned benefits from 5 practitioners
Practice locations: Cape Coral, FL; Fort Myers, FL; Lecanto, FL; Lehigh Acres, FL

National Provider Directory

National Provider Directory
Part of
Axel Health LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1700339108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 GRIFFIN BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082016",
            "telephone_number": "239-313-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 CHAMPION RING RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339055599",
            "telephone_number": "561-869-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXEL PODIATRY SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AXEL HEALTH LLC",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "SUMEET",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-872-9734",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.