NPIMap

Organization Active NPI

Lepoer Podiatry, Inc.

  • Clinic/Center
  • Providence, RI
National Provider Identifier
1871123372
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LEPOER PODIATRY, INC.
Practice address
1 Randall SQ Ste 408
Providence, RI 02904-7405
Phone
(401) 453-2000
Fax
(401) 453-2002
NPI assigned
Jan 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2024

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

Authorized official

Name
Krysia Lepoer, DPMNPI 1679665111
Title
Authorized Official
Phone
(401) 453-2001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X
Clinic/Center 261Q00000X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

1 Randall SQ Ste 408
Providence, RI 02904-7405

Mailing address

1 Randall SQ Ste 408
Providence, RI 02904-7405
Phone (401) 453-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200304000519 RI Part B Supplier - Clinic/Group Practice 3870920838 Receives reassigned benefits from 2 practitioners
Practice locations: Providence, RI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lepoer Podiatry Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Randall Sq
Ste 408
Providence, RI 02904
Phone (401) 272-6602

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1871123372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ STE 408",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029047405",
            "telephone_number": "401-453-2000",
            "fax_number": "401-453-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ STE 408",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029047405",
            "telephone_number": "401-453-2000",
            "fax_number": "401-453-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEPOER PODIATRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "LEPOER",
        "authorized_official_first_name": "KRYSIA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "401-453-2001",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; 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.