Penobscot Family Foot and Ankle Center

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD1032 Issued in ME

Legal business name

PENOBSCOT FAMILY FOOT AND ANKLE CENTER

Practice address

205 French St
Bangor, ME 04401-5064

Phone

(207) 945-5554

Fax

(207) 945-5196

NPI assigned

Sep 3, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Diane Maria Desantis

Title

Billing Manager

Phone

(781) 231-7026

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heidi A Brewer, DPM

  • Primary Podiatric Medicine Podiatrist
  • Bangor, ME
  • NPI 1710030226
  Medicare reassignment

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1841690377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 FRENCH ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015064",
            "telephone_number": "207-945-5554",
            "fax_number": "207-945-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 FRENCH ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015064",
            "telephone_number": "207-945-5554",
            "fax_number": "207-945-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT FAMILY FOOT AND ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "DESANTIS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "781-231-7026",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ME",
            "license": "POD1032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penobscot Community Health Center (Capehart Community Health Center)
• Penobscot Community Health Center (PCHC Infusion Center)
• Penobscot Community Health Center (PCHC Walk In - Pediatric)
• Penobscot Community Health Center (PCHC X Ray)
• Penobscot Community Health Center (James F. Doughty School)
• Penobscot Respiratory
• Penobscot Surgical Care, P.a.
• Penobscot Valley Dermatology, P.a.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.

• Foot & Ankle Surgery Podiatrist in Bangor, ME
• Providers in Bangor, ME by specialty
• Foot & Ankle Surgery Podiatrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.