Organization Active NPI

Anthony Emelianchik DPM PA

  • Podiatrist
  • Eustis, FL
National Provider Identifier
1811955099
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO 2285 Issued in FL
Legal business name
ANTHONY EMELIANCHIK DPM PA
Practice address
2051 Prevatt St
Suite B
Eustis, FL 32726-6141
Phone
(352) 589-4601
Fax
(352) 589-1998
NPI assigned
May 4, 2006
Last updated
Sep 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Dr. Anthony J Emelianchik, DPMNPI 1003864042
Title
Owner
Phone
(352) 589-4601

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
Podiatrist 213E00000X PO 2285 FL Primary

Addresses

Primary practice location

2051 Prevatt St
Suite B
Eustis, FL 32726-6141

Mailing address

2051 Prevatt St
Suite B
Eustis, FL 32726-6141
Phone (352) 589-4601

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060602000104 FL Part B Supplier - Clinic/Group Practice 3476564667 Receives reassigned benefits from 1 practitioner
Practice locations: Eustis, FL
O20100930004298 FL DME Supplier - Physician - Podiatry 3476564667 Practice locations: Eustis, FL

National Provider Directory

National Provider Directory

Locations

2051 Prevatt St
Ste B
Eustis, FL 32726
Phone (352) 589-4601

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1811955099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 PREVATT ST",
            "address_2": "SUITE B",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266141",
            "telephone_number": "352-589-4601",
            "fax_number": "352-589-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 PREVATT ST",
            "address_2": "SUITE B",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266141",
            "telephone_number": "352-589-4601",
            "fax_number": "352-589-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY EMELIANCHIK DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "EMELIANCHIK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-589-4601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 2285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.