Achilles Foot Health Center, L.L.C.
Organization Active NPI Foot Surgery Podiatrist · North Haven, CT
NPI 1861670770 · NPPES record last updated Feb 20, 2015
Key facts
- NPI
- 1861670770
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot Surgery Podiatrist 213ES0131X
- License
- 00709 (CT)
- Legal business name
- ACHILLES FOOT HEALTH CENTER, L.L.C.
- Practice address
- 20 Washington Ave
Suite 212
North Haven, CT 06473-2343 - Phone
- (203) 239-1119
- Fax
- (203) 234-1832
- NPI assigned
- Feb 1, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard W. Durocher, D.P.M.
- Title
- Owner of Practice
- Phone
- (203) 239-1119
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090113000475 | CT | Part B Supplier - Clinic/Group Practice | 1557424843 |
Receives reassigned benefits from 1 practitioner Practice locations: North Haven, CT |
| O20100930066269 | CT | DME Supplier - Physician - Podiatry | 1557424843 | Practice locations: North Haven, CT |
National Provider Directory
Locations
20 Washington Ave
North Haven, CT 06473
Phone (203) 239-1119
20 Washington Ave
#212
North Haven, CT 06473
Phone (203) 239-1119
20 Washington Ave
Ste 213
North Haven, CT 06473
Phone (203) 239-1119
20 Washington Ave
Ste 212
North Haven, CT 06473
Phone (203) 239-1119
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist |
213ES0131X | 00709 | CT | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 00709 | CT |
Addresses
Primary practice location
20 Washington Ave
Suite 212
North Haven, CT 06473-2343
Mailing address
20 Washington Ave
Suite 212
North Haven, CT 06473-2343
Phone (203) 239-1119
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2704187 | Other | CT | UNTIED HEALTHCARE |
| 004191277 | Medicaid | CT | |
| 103244500 | Other | CT | FEDERAL DOL OWCP |
| CPD# 1392050 | Other | CT | AETNA - COVENTRY-FIRST HEALTH |
| 007090 | Other | CT | CONNECTICARE |
| 11066538 | Other | CT | MULTIPLAN |
| 008003227 | Medicaid | CT | |
| DO3120 | Other | CT | MEDICARE RAILROAD |
| 030000709CT01 | Other | CT | ANTHEM |
| 2110284 | Other | CT | AETNA |
| P1271789 | Other | CT | OXFORD |
| 60353065001 | Other | CT | CIGNA |
Other names
- Advanced Footcare Specialists of Connecticut L.L.C.
Other providers in North Haven, CT
- William Scott Abbott
- Abraham Yale & Carol Callahan PTRS Associated Podiatrists of N Haven
- Absolute Transportation LLC
- Gerard Acampora
- Advanced Physical Medicine, LLC.
- Advenientishealth LLC
- Anthony Ah-Mu
- Jinyong Ahn
- Reem Alaa Alami
All providers in North Haven, CT · Foot Surgery Podiatrist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.