Philip B Sextro, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

135 Issued in NE

Practice address

620 Diers Ave
Grand Island, NE 68802-5020

Phone

(308) 381-0404

Fax

(308) 381-0408

NPI assigned

May 24, 2005

Last updated

Aug 10, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Central Nebraska Orthopedics & Sports Medicine, P.C.

  • Orthopaedic Surgery Physician
  • Grand Island, NE
  • NPI 1538163092
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1851394738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DIERS AVE",
            "address_2": "PO BOX 5020",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025020",
            "telephone_number": "308-381-0404",
            "fax_number": "308-381-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 DIERS AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025020",
            "telephone_number": "308-381-0404",
            "fax_number": "308-381-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTRO",
        "first_name": "PHILIP",
        "middle_name": "B",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "213E00000X",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "280175",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480021804",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC CIGNA",
            "identifier": "0152470001",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "470624949",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0152470001",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02549",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47062497913",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miriam Serrano
• Gary L Settje, M.D.
• Fabian Eduardo Sevilla Luzuriaga, LMHP 6352
• Valerie Sewerynow
• Gregory S Sextro, M.D.
• Kathryn K Shafer, SLP
• Aria Shakeri, M.D.
• Anna Marie Shaneyfelt
• Danielle Leigh Shaneyfelt
• Shannon Peterson Counseling LLC

• Foot & Ankle Surgery Podiatrist in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Foot & Ankle Surgery Podiatrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.