Individual provider Active NPI

Larry B Dyal Jr., DPM

  • Foot & Ankle Surgery Podiatrist
  • Brunswick, GA
National Provider Identifier
1871581744
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD000997 Issued in GA
Practice address
10 Professional Dr
Brunswick, GA 31520-3774
Phone
(912) 265-0709
Fax
(912) 264-5712
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD000997 GA Primary

Addresses

Primary practice location

10 Professional Dr
Brunswick, GA 31520-3774

Mailing address

10 Professional Dr
Brunswick, GA 31520-3774
Phone (912) 265-0709

Other identifiers 1

IdentifierTypeStateIssuer
400885615DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040702000830 GA Practitioner - Podiatry 6103803507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Assoc LLCGroup PAC ID 1355327107, 20 clinicians

Practice addresses (Care Compare)

10 Professional Dr
Brunswick, GA 31520-3774
Phone (912) 265-0709

501 W Oneida St
Waycross, GA 31501-5337

501 W Oneida St
Waycross, GA 31501-6209
Phone (912) 283-6471

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue23
Removal of skin lesions1-10
Removal of nail tissue368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Associates, LLC Foot & Ankle Surgery CurrentSince Jan 1, 2021 Accepting new patients
Ankle & Foot Associates, LLC Foot & Ankle Surgery CurrentSince Jan 1, 2021 Accepting new patients
Gary M. Grolemund DPM Past Accepting new patients

Locations

10 Professional Dr
Brunswick, GA 31520
Phone (912) 264-6150

501 W Oneida St
Waycross, GA 31501
Phone (912) 283-6471

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 1

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1871581744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203774",
            "telephone_number": "912-265-0709",
            "fax_number": "912-264-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203774",
            "telephone_number": "912-265-0709",
            "fax_number": "912-264-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYAL",
        "first_name": "LARRY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400885615D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.