Gordon E Fosdick, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

00723 Issued in CT

Practice address

470 Main St
Middlefield, CT 06455-1210

Phone

(860) 349-8500

Fax

(860) 349-3081

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affiliated Foot Care Center, LLC

  • Podiatrist
  • Middlefield, CT
  • NPI 1295807451
  Medicare reassignment NPD Authorized official
• Affiliated Foot Care Center, LLC

  • Durable Medical Equipment & Medical Supplies
  • Middlefield, CT
  • NPI 1609048370
  NPD Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1740206192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARKWAY S",
            "address_2": "SUITE 304",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851234",
            "telephone_number": "860-442-7027",
            "fax_number": "860-444-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 MAIN ST",
            "city": "MIDDLEFIELD",
            "state": "CT",
            "postal_code": "064551210",
            "telephone_number": "860-349-8500",
            "fax_number": "860-349-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSDICK",
        "first_name": "GORDON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "00723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "000723",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "030000723CT05",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004206951",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Middlefield, CT
• Providers in Middlefield, CT by specialty
• Foot Surgery Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.