NPIMap

Individual provider Active NPI

Jeremy Wayne Wood, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
National Provider Identifier
1831159128
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0307 Issued in NV
Practice address
4580 S Eastern Ave
Suite 30
Las Vegas, NV 89119-6100
Phone
(702) 731-3338
Fax
(702) 731-3341
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0307 NV Primary

Addresses

Primary practice location

4580 S Eastern Ave
Suite 30
Las Vegas, NV 89119-6100

Mailing address

4580 S Eastern Ave
Suite 30
Las Vegas, NV 89119-6100
Phone (702) 731-3338

Other identifiers 2

IdentifierTypeStateIssuer
100503070MedicaidNV
P00257221OtherNVRAILROAD MEDICARE ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040121000519 NV Practitioner - Podiatry 2961316393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunrise Foot and Ankle LLCGroup PAC ID 3971771411, 3 clinicians

Practice addresses (Care Compare)

2950 E Flamingo Rd
Suite a
Las Vegas, NV 89121-5208
Phone (702) 731-3338

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue258
Removal of nail tissue1315
Removal or shaving of skin growth490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1662TXMDBehavioral Analyst
0307NVMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan K Anderson D P M P C Podiatrist PastSince Jan 10, 2024 Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Transitional Hospitals Corporation of Nevada, LLC Past Accepting new patients
Eastern Podiatry LLC Podiatrist PastSince Nov 4, 1998 Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Dignity Health Past Accepting new patients

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1831159128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE",
            "address_2": "SUITE 30",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-731-3338",
            "fax_number": "702-731-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE",
            "address_2": "SUITE 30",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-731-3338",
            "fax_number": "702-731-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JEREMY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "0307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503070",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID #",
            "identifier": "P00257221",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.