Organization Active NPI

Broward Foot and Ankle Specialist P a

  • Foot & Ankle Surgery Podiatrist
  • Pompano Beach, FL
National Provider Identifier
1790046290
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BROWARD FOOT AND ANKLE SPECIALIST P A
Practice address
2205 Bay Dr
Pompano Beach, FL 33062-2912
Phone
(917) 582-4010
Fax
(718) 766-8606
NPI assigned
Jun 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Dr. Efrosini Fotopoulos, DPMNPI 1255595047
Title
President
Phone
(917) 582-4010

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

2205 Bay Dr
Pompano Beach, FL 33062-2912

Mailing address

2205 Bay Dr
Pompano Beach, FL 33062-2912
Phone (917) 582-4010

Other identifiers 1

IdentifierTypeStateIssuer
010144200MedicaidFL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130522000205 FL Part B Supplier - Clinic/Group Practice 4183862766 Receives reassigned benefits from 1 practitioner
Practice locations: Pompano Beach, FL; Ft Lauderdale, FL
O20150611000728 FL DME Supplier - Physician - Podiatry 4183862766 Practice locations: Pompano Beach, FL

National Provider Directory

National Provider Directory

Locations

1600 N Federal Hwy
#A
Pompano Beach, FL 33062
Phone (754) 234-0984

Networks

  • HealthSun Health Plans Network

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": "1338508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1790046290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 BAY DR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330622912",
            "telephone_number": "917-582-4010",
            "fax_number": "718-766-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 BAY DR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330622912",
            "telephone_number": "917-582-4010",
            "fax_number": "718-766-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWARD FOOT AND ANKLE SPECIALIST P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-01",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "FOTOPOULOS",
        "authorized_official_first_name": "EFROSINI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-582-4010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010144200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.