Organization Active NPI

Pinnacle Foot and Ankle Centers, LLC

  • Podiatrist
  • Port St Lucie, FL
National Provider Identifier
1780204602
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PINNACLE FOOT AND ANKLE CENTERS, LLC
Practice address
1801 SE Hillmoor Dr Ste a-103
Port St Lucie, FL 34952-7545
Phone
(407) 844-4499
NPI assigned
Apr 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Authorized official

Name
Dr. Danielle Matrece Green-Watson, DPM
Title
Owner
Phone
(772) 742-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1801 SE Hillmoor Dr Ste a-103
Port St Lucie, FL 34952-7545

Mailing address

1801 SE Hillmoor Dr Ste a-103
Port St Lucie, FL 34952-7545
Phone (772) 742-7118

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.pinnaclefootcenter.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200528002345 FL Part B Supplier - Clinic/Group Practice 8224459383 Receives reassigned benefits from 1 practitioner
Practice locations: Port St Lucie, FL
O20200817000782 FL DME Supplier - Physician - Podiatry 8224459383 Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1780204602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE A-103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "772-742-7118",
            "fax_number": "772-228-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE A-103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "407-844-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE FOOT AND ANKLE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "GREEN-WATSON",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "MATRECE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-742-7118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.pinnaclefootcenter.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1801 SE Hillmoor Dr Ste A-103",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349527545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.

Verify at the official NPI Registry.