Individual provider Active NPI

Murtuza A. Peerbhai, DPM

  • Foot & Ankle Surgery Podiatrist
  • Monticello, IN
National Provider Identifier
1740316124
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07001110A Issued in IN
Practice address
101 W Broadway St
Apartment 311
Monticello, IN 47960-2110
Phone
(617) 510-2656
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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 07001110A IN Primary

Addresses

Primary practice location

101 W Broadway St
Apartment 311
Monticello, IN 47960-2110

Mailing address

101 W Broadway St
Apartment 311
Monticello, IN 47960-2110
Phone (617) 510-2656

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101006000659 IN Practitioner - Podiatry 6305971755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1281 Win Hentschel Blvd
Suite 1579
West Lafayette, IN 47906-4357
Phone (765) 430-6963

Hospital & facility affiliations

  • Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue320
Removal or shaving of skin growth317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000851CTMDPsychologist
07001110AINMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Monticello Podiatry LLC CurrentSince Jun 26, 2011 Accepting new patients
Monticello Podiatry LLC Past Accepting new patients
Monticello Podiatry LLC PastSince Jun 26, 2011 Accepting new patients

Locations

101 W Broadway St
Apt 311
Monticello, IN 47960
Phone (617) 510-2656

101 W Broadway St
Monticello, IN 47960
Phone (574) 583-4211

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1740316124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W BROADWAY ST",
            "address_2": "APARTMENT 311",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602110",
            "telephone_number": "617-510-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W BROADWAY ST",
            "address_2": "APARTMENT 311",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479602110",
            "telephone_number": "617-510-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEERBHAI",
        "first_name": "MURTUZA",
        "middle_name": "A.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001110A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, IN

Sources for this page

Verify at the official NPI Registry.