Active NPI
Modern Foot & Ankle Centers, PLLC
- Podiatrist
- Chandler, AZ
National Provider Identifier
1760006290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- MODERN FOOT & ANKLE CENTERS, PLLC
- Practice address
- 600 S Dobson Rd Ste E40
Chandler, AZ 85224-5693 - Phone
- (480) 909-3700
- Fax
- (877) 839-9972
- NPI assigned
- Jun 1, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David A Laurino, DPM
- Title
- Owner
- Phone
- (480) 909-3700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
600 S Dobson Rd Ste E40
Chandler, AZ 85224-5693
Mailing address
2680 S Val Vista Dr Ste 177
Gilbert, AZ 85295-1674
Phone (480) 909-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200610002790 | AZ | DME Supplier - Physician - Podiatry | 5991126898 | Practice locations: Chandler, AZ |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Modern Foot Ankle
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Podiatrist
- Gilbert, AZ
- NPI 1144840273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1593561600000",
"number": "1760006290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2680 S VAL VISTA DR STE 177",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852951674",
"telephone_number": "480-909-3700",
"fax_number": "877-839-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S DOBSON RD STE E40",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852245693",
"telephone_number": "480-909-3700",
"fax_number": "877-839-9972"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MODERN FOOT & ANKLE CENTERS, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-01",
"last_updated": "2020-07-01",
"certification_date": "2020-07-01",
"status": "A",
"authorized_official_last_name": "LAURINO",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "480-909-3700",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.