NPIMap

Organization Active NPI

Flagler Family Medicine PA

Doing business as Northeast Florida Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
National Provider Identifier
1821406679
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FLAGLER FAMILY MEDICINE PA
Doing business as
Northeast Florida Foot and Ankle
Practice address
315 W Town PL Ste 1
St Augustine, FL 32092-3105
Phone
(904) 429-4736
Fax
(904) 679-3169
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Kirsten Satkowiak
Title
Billing Manager
Phone
(904) 547-2808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

315 W Town PL Ste 1
St Augustine, FL 32092-3105

Mailing address

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 547-2808

Other identifiers 1

IdentifierTypeStateIssuer
252488100MedicaidFL

Other names 1

  • NORTHEAST FLORIDA FOOT AND ANKLE Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2014955Flagler Family Medicine PA315 W Town PL Unit 1, Saint Augustine, FL 32092Certificate of waiverOct 18, 2026

National Provider Directory

National Provider Directory

Locations

1301 N Orange Ave
Ste 101
Green Cove Springs, FL 32043
Phone (904) 429-4736

28 Old Kings Rd N
Unit A
Palm Coast, FL 32137
Phone (904) 826-3469

3700 US Highway 1 S
Saint Augustine, FL 32086
Phone (904) 429-4736

6277 A1A S
Unit 101102
Saint Augustine, FL 32080
Phone (904) 826-3469

52 Tuscan Way
Ste 205
St Augustine, FL 32092
Phone (904) 826-3469

130 Health Park Blvd
St Augustine, FL 32086
Phone (904) 826-3469

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1821406679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-547-2808",
            "fax_number": "904-679-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W TOWN PL STE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923105",
            "telephone_number": "904-429-4736",
            "fax_number": "904-679-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGLER FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "SATKOWIAK",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-547-2808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252488100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST FLORIDA FOOT AND ANKLE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTHEAST FLORIDA FOOT AND ANKLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.