Active NPI
Risa L Vinarub, DPM
- Foot & Ankle Surgery Podiatrist
- Merritt Island, FL
National Provider Identifier
1700857406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PO2414
- Practice address
- 1205 N Courtenay Pkwy
Merritt Island, FL 32953-5500 - Phone
- (321) 452-5133
- Fax
- (321) 449-8713
- NPI assigned
- Jan 30, 2006
- Last updated
- Apr 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO2414 | FL | Primary |
Addresses
Primary practice location
1205 N Courtenay Pkwy
Merritt Island, FL 32953-5500
Mailing address
1205 N Courtenay Pkwy
Merritt Island, FL 32953-5500
Phone (321) 452-5133
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480027718 | Other | FL | MEDICARE RAILROAD |
| 65393 | Other | FL | BLUE CROSS BLUE SHEILD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO2414 | FL | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brevard Healthworx Inc | Foot & Ankle Surgery | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brevard Podiatry Group
- Foot & Ankle Surgery Podiatrist
- Merritt Island, FL
- NPI 1477590362
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209513600000",
"number": "1700857406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 N COURTENAY PKWY",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329535500",
"telephone_number": "321-452-5133",
"fax_number": "321-449-8713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 N COURTENAY PKWY",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329535500",
"telephone_number": "321-452-5133",
"fax_number": "321-449-8713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINARUB",
"first_name": "RISA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2008-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "PO2414",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "480027718",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "65393",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.