Organization Active NPI

Premier Podiatry Associates, LLC

  • Foot & Ankle Surgery Podiatrist
  • Altamonte Springs, FL
National Provider Identifier
1700691672
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PREMIER PODIATRY ASSOCIATES, LLC
Practice address
616 E Altamonte Dr.
Ste #205
Altamonte Springs, FL 32701-4810
Phone
(407) 813-2413
Fax
(407) 792-1019
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Mrs. Cristina Maria Corrales-Aguilar
Title
Office Manager
Phone
(407) 813-2413

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Public Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP0504X
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X
Radiology PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ER0200X
Sports Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

616 E Altamonte Dr.
Ste #205
Altamonte Springs, FL 32701-4810

Mailing address

616 E Altamonte Dr Ste 205
Altamonte Springs, FL 32701-4810
Phone (407) 813-2413

Other identifiers 1

IdentifierTypeStateIssuer
126433900MedicaidFL

Other names 1

  • Premier Podiatry Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250212001218 FL Part B Supplier - Clinic/Group Practice 7012447618 Receives reassigned benefits from 2 practitioners
Practice locations: Altamonte Springs, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1700691672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E ALTAMONTE DR STE 205",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014810",
            "telephone_number": "407-813-2413",
            "fax_number": "407-378-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E ALTAMONTE DR.",
            "address_2": "STE #205",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014810",
            "telephone_number": "407-813-2413",
            "fax_number": "407-792-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PODIATRY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "CORRALES-AGUILAR",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-813-2413",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Public Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126433900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Podiatry Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.