NPIMap

Organization Active NPI

Elite Podiatry LLC

  • Podiatrist
  • Hollywood, FL
National Provider Identifier
1700374667
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ELITE PODIATRY LLC
Practice address
3381 N 41St CT
Hollywood, FL 33021-1940
Phone
(818) 317-4127
NPI assigned
Apr 26, 2018
Last updated
Dec 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Authorized official

Name
Elliot FialkoffNPI 1710363692
Title
Ceo
Phone
(818) 317-4127

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

3381 N 41St CT
Hollywood, FL 33021-1940

Mailing address

3381 N 41St CT
Hollywood, FL 33021-1940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181226001606 FL Part B Supplier - Clinic/Group Practice 6204171010 Receives reassigned benefits from 18 practitioners

National Provider Directory

National Provider Directory

Locations

1859 Van Buren St
Fl 1
Hollywood, FL 33020

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1700374667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 N 41ST CT",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 N 41ST CT",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330211940",
            "telephone_number": "818-317-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "FIALKOFF",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-317-4127"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.