Individual provider Active NPI

Petrusia Ann Howansky, DPM

  • Podiatrist
  • Phoenix, AZ
National Provider Identifier
1760489033
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0535 Issued in AZ
Practice address
520 E Bethany Home Rd
Phoenix, AZ 85012-1207
Phone
(602) 264-9121
Fax
(602) 264-9122
NPI assigned
Jul 1, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0535 AZ Primary

Addresses

Primary practice location

520 E Bethany Home Rd
Phoenix, AZ 85012-1207

Mailing address

520 E Bethany Home Rd
Phoenix, AZ 85012-1207
Phone (602) 264-9121

Other identifiers 6

IdentifierTypeStateIssuer
861027930OtherAZOTHER COMMERCIAL INSURANC
480032678OtherAZPALMETTO
AZ0194260OtherAZBLUE CROSS BLUE SHIELD AZ
126004OtherAZHEALTH NET
575483MedicaidAZ
5662648OtherAZAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051103000982 AZ Practitioner - Podiatry 5890713283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

520 E Bethany Home Rd
Phoenix, AZ 85012-1207

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of skin lesions1-10
Removal of nail tissue1146
Removal or shaving of skin growth981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0535AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Footcare, PC Podiatrist CurrentSince Dec 1, 2011 Accepting new patients
Federal Hill Podiatry Group PastSince Aug 1, 1991 Accepting new patients
Tollgate Chiropractic LTD Past Accepting new patients

Locations

520 E Bethany Home Rd
Phoenix, AZ 85012
Phone (602) 264-9121

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, 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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760489033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121207",
            "telephone_number": "602-264-9121",
            "fax_number": "602-264-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121207",
            "telephone_number": "602-264-9121",
            "fax_number": "602-264-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWANSKY",
        "first_name": "PETRUSIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER COMMERCIAL INSURANC",
            "identifier": "861027930",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "480032678",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AZ",
            "identifier": "AZ0194260",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "126004",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575483",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5662648",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.