Individual provider Active NPI

Steven P. Saccoman, DPM

  • Podiatrist
  • Willmar, MN
National Provider Identifier
1841241775
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
570 Issued in MN
Practice address
2100 19TH Ave SW
Willmar, MN 56201-5286
Phone
(320) 235-2544
Fax
(320) 235-2494
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 570 MN Primary

Addresses

Primary practice location

2100 19TH Ave SW
Willmar, MN 56201-5286

Mailing address

2100 19TH Ave SW
Willmar, MN 56201-5286
Phone (320) 235-2544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040820000932 MN Practitioner - Podiatry 6204800790 Practice locations: Appleton, MN; Madison, MN; Ortonville, MN; Willmar, MN

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2100 19TH Ave SW
Willmar, MN 56201-4982
Phone (320) 235-2544

2100 19TH Ave SW
Willmar, MN 56201-5286

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.21 of 100Reported as group
Quality
92.56
Promoting interoperability
100
Improvement activities
40
Cost
41.48

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue76
Removal of nail tissue1410
Removal or shaving of skin growth27
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
570MNMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Willmar Foot & Ankle Clinic PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ssaccoman29813@direct.centracare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1841241775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015286",
            "telephone_number": "320-235-2544",
            "fax_number": "320-235-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 19TH AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562015286",
            "telephone_number": "320-235-2544",
            "fax_number": "320-235-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCOMAN",
        "first_name": "STEVEN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

Verify at the official NPI Registry.