Premier Care Podiatry PC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

PREMIER CARE PODIATRY PC

Doing business as

Premier Care Podiatry

Practice address

4605 Frankford Ave
Philadelphia, PA 19124-5803

Phone

(215) 289-7007

Fax

(215) 289-3400

NPI assigned

Jul 26, 2021

Last updated

Aug 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie BaezaNPI 1942477021

Title

Owner

Phone

(215) 289-7007

Specialties & licenses 1

Addresses

Other names 1

• Premier Care Podiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leslie Baeza, DPM

  • Podiatrist
  • Philadelphia, PA
  • NPI 1942477021
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1740953934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245803",
            "telephone_number": "215-289-7007",
            "fax_number": "215-289-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245803",
            "telephone_number": "215-289-7007",
            "fax_number": "215-289-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "BAEZA",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-289-7007"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Care Podiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Care Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marisa Sara Prelack, M.D.
• Remy Prem
• Smrithi Prem, MD, PHD
• Premier Adult Daycare Inc
• Premier Care Lab Services LLC
• Premier Concierge Home Care LLC
• Premier Dentistry of Philadelphia LLC
• Premier Endodontics, PC
• Premier Family Dental, LLC
• Premier Family Practice of Pennsylvania LLC (Premier Clinic LLC)

• Podiatric Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatric Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.