NPIMap

Individual provider Active NPI

Andrew Peacock, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1851730063
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006489 Issued in PA
Practice address
3110 Grant Ave
Philadelphia, PA 19114-2542
Phone
(215) 464-6600
NPI assigned
Jun 20, 2013
Last updated
Apr 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X SC006489 PA Primary

Addresses

Primary practice location

3110 Grant Ave
Philadelphia, PA 19114-2542

Mailing address

3110 Grant Ave
Philadelphia, PA 19114-2542
Phone (215) 464-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170822001880 PA Practitioner - Podiatry 2163794470 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2800 Kelly Rd
Suite 300
Warrington, PA 18976-3630
Phone (215) 348-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue141
Removal of skin lesions1-10
Removal of nail tissue19
Removal or shaving of skin growth22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bucks County Orthopedic Specialists, PC CurrentSince Dec 1, 2019 Accepting new patients
Highland Park Podiatry,PC Foot & Ankle Surgery CurrentSince Aug 1, 2017 Accepting new patients
Dr. H. D. Schoenhaus , P.C. Foot & Ankle Surgery CurrentSince Nov 21, 2017 Accepting new patients
Bucks County Orthopedic Specialists, PC CurrentSince Dec 1, 2019 Accepting new patients

Locations

1740 South St
Ste 500
Philadelphia, PA 19146
Phone (215) 546-1618

8011 W Chester Pike
Upper Darby, PA 19082
Phone (610) 449-2345

2800 Kelly Rd
Ste 300
Warrington, PA 18976
Phone (215) 348-3068

Interoperability endpoints

  • Direct secure messaging: andrew.peacock@dhcp.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1851730063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142542",
            "telephone_number": "215-464-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 GRANT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191142542",
            "telephone_number": "215-464-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "ANDREW",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-20",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.