Organization Active NPI

Glenville Foot and Ankle Center, Inc.

  • Podiatrist
  • Cleveland, OH
National Provider Identifier
1760618714
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
GLENVILLE FOOT AND ANKLE CENTER, INC.
Practice address
10701 St. Clair Ave.
Cleveland, OH 44108
Phone
(216) 268-0800
Fax
(216) 268-0801
NPI assigned
Jun 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Authorized official

Name
Sai Man Lee, DPMNPI 1548222888
Title
President
Phone
(216) 268-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X OH Primary
Durable Medical Equipment & Medical Supplies 332B00000X 36003361 OH

Addresses

Primary practice location

10701 St. Clair Ave.
Cleveland, OH 44108

Mailing address

10701 St. Clair Ave.
Cleveland, OH 44108
Phone (931) 206-4362

Other identifiers 1

IdentifierTypeStateIssuer
2973260MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090826000201 OH Part B Supplier - Clinic/Group Practice 2264587302 Receives reassigned benefits from 2 practitioners
Practice locations: Cleveland, OH
O20100930100739 OH DME Supplier - Physician - Podiatry 2264587302 Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory

Locations

10701 Saint Clair Ave
Cleveland, OH 44108
Phone (216) 268-0800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1760618714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 ST. CLAIR AVE.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44108",
            "telephone_number": "931-206-4362",
            "fax_number": "606-257-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 ST. CLAIR AVE.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44108",
            "telephone_number": "216-268-0800",
            "fax_number": "216-268-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENVILLE FOOT AND ANKLE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-04",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SAI",
        "authorized_official_middle_name": "MAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-268-0800",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "36003361",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2973260",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.