Individual provider Active NPI

John Savidakis Jr., DPM

  • Podiatrist
  • Clearwater, FL
National Provider Identifier
1750454740
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POOOO2430 Issued in FL
Practice address
2701 Park Dr Ste 6
Clearwater, FL 33763-1021
Phone
(727) 796-1490
Fax
(727) 797-5611
NPI assigned
Nov 16, 2006
Last updated
Aug 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POOOO2430 FL Primary

Addresses

Primary practice location

2701 Park Dr Ste 6
Clearwater, FL 33763-1021

Mailing address

926 Valley View Cir
Palm Harbor, FL 34684-4463
Phone (727) 796-1490

Other identifiers 2

IdentifierTypeStateIssuer
480027243OtherFLRAILROAD MEDICARE
390339700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040331000853 FL Practitioner - Podiatry 0345232369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2701 Park Dr
Suite 2
Clearwater, FL 33763-1021

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POOOO2430FLMDPodiatrist

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1750454740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 VALLEY VIEW CIR",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346844463",
            "telephone_number": "727-796-1490",
            "fax_number": "727-797-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PARK DR STE 6",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631021",
            "telephone_number": "727-796-1490",
            "fax_number": "727-797-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAVIDAKIS",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "POOOO2430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480027243",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390339700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.