Organization Active NPI

Arizona Footcare, PC

  • Podiatrist
  • Phoenix, AZ
National Provider Identifier
1821366154
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
535 Issued in AZ
Legal business name
ARIZONA FOOTCARE, PC
Practice address
520 E Bethany Home Rd
Phoenix, AZ 85012-1207
Phone
(602) 264-9121
Fax
(602) 264-9122
NPI assigned
Dec 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Authorized official

Name
Dr. Petrusia Ann Howansky, DPMNPI 1760489033
Title
President/Podiatrist
Phone
(602) 264-9121

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 535 AZ Primary

Addresses

Primary practice location

520 E Bethany Home Rd
Phoenix, AZ 85012-1207

Mailing address

520 E Bethany Home Rd
Phoenix, AZ 85012-1207
Phone (602) 264-9121

Other identifiers 2

IdentifierTypeStateIssuer
480032678OtherAZPALMETTO BGA
575483MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120220000731 AZ Part B Supplier - Clinic/Group Practice 1951569177 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

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": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1821366154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121207",
            "telephone_number": "602-264-9121",
            "fax_number": "602-264-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121207",
            "telephone_number": "602-264-9121",
            "fax_number": "602-264-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA FOOTCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "HOWANSKY",
        "authorized_official_first_name": "PETRUSIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/PODIATRIST",
        "authorized_official_telephone_number": "602-264-9121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO BGA",
            "identifier": "480032678",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575483",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.