Individual provider Active NPI

Stephanie Lee Liette, DPM

  • Foot & Ankle Surgery Podiatrist
  • Florence, KY
National Provider Identifier
1780171637
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
281873 Issued in KY
Practice address
7370 Turfway Rd
Florence, KY 41042-4895
Phone
(859) 212-0175
Fax
(859) 746-7464
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36004004 OH
Foot & Ankle Surgery Podiatrist 213ES0103X 07001411A IN
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X 281873 KY Primary

Addresses

Primary practice location

7370 Turfway Rd
Florence, KY 41042-4895

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-0175

Other names 1

  • Stephanie Lee Petrofski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230421002438 IN Practitioner - Podiatry 2961818018 Reassigns benefits to 1 organization
I20230427000593 KY Practitioner - Podiatry 2961818018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, shared by 11 NPIs, 803 clinicians

Practice addresses (Care Compare)

1640 Flossie Dr
Greendale, IN 47025-8424
Phone (855) 277-4230

7370 Turfway Rd
Florence, KY 41042-4895
Phone (859) 212-5125

Hospital & facility affiliations

  • St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
  • St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue201
Removal of skin lesions1-10
Removal of nail tissue394
Removal or shaving of skin growth71
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07001411AINMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Foot & Ankle Surgery CurrentSince May 30, 2023 Accepting new patients
Summit Medical Group, Inc Current Accepting new patients
Choice Podiatry Associates Inc Podiatrist CurrentSince Mar 7, 2021 Accepting new patients
Summit Medical Group, Inc. Podiatrist CurrentSince May 30, 2023 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

4455 Bridgetown Rd
Cincinnati, OH 45211
Phone (513) 574-2424

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1780171637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-0175",
            "fax_number": "859-746-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 TURFWAY RD",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424895",
            "telephone_number": "859-212-0175",
            "fax_number": "859-746-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETTE",
        "first_name": "STEPHANIE",
        "middle_name": "LEE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36004004",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07001411A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "281873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "PETROFSKI",
            "middle_name": "LEE",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.