Individual provider Active NPI

Ronald Joseph Clemente, DPM

  • Foot & Ankle Surgery Podiatrist
  • Schaumburg, IL
National Provider Identifier
1730125097
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016002780 Issued in IL
Practice address
1015 W Wise Rd
Ste 101
Schaumburg, IL 60193-3777
Phone
(847) 352-0200
Fax
(847) 352-0600
NPI assigned
Jun 22, 2006
Last updated
Mar 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016002780 IL Primary

Addresses

Primary practice location

1015 W Wise Rd
Ste 101
Schaumburg, IL 60193-3777

Mailing address

1015 W Wise Rd
Ste 101
Schaumburg, IL 60193-3777
Phone (847) 352-0200

Other identifiers 2

IdentifierTypeStateIssuer
480028503OtherILRAILROAD MEDICARE
0060000949OtherILBCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
016002780ILMDFoot & Ankle Surgery Podiatrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1730125097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W WISE RD",
            "address_2": "STE 101",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933777",
            "telephone_number": "847-352-0200",
            "fax_number": "847-352-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W WISE RD",
            "address_2": "STE 101",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933777",
            "telephone_number": "847-352-0200",
            "fax_number": "847-352-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016002780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480028503",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0060000949",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.