NPIMap

Organization Active NPI

Integrated Foot and Ankle Specialists of PA LLC

  • Podiatric Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1881404705
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC
Practice address
5735 Ridge Ave Ste 208
Philadelphia, PA 19128-1747
Phone
(215) 593-2878
NPI assigned
Jan 13, 2025
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Teresa Leonarda Ciaccio
Title
Chief Operating Officer
Phone
(516) 993-8666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5735 Ridge Ave Ste 208
Philadelphia, PA 19128-1747

Mailing address

100 Front St Ste 970
Conshohocken, PA 19428-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260216002267 PA DME Supplier - Physician - Podiatry 1153704754 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Integrated Foot and Ankle Specialists of PA LLC16 organizations share this tax ID, including this one
Part of
Integrated Foot and Ankle Specialists of PA LLC

Other organizations with this tax ID 15

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

View all 15

Locations

100 Front St
Ste 970
Conshohocken, PA 19428

471 Pequea Ave
Ste 208
Honey Brook, PA 19344
Phone (610) 269-0800

104 Fite Way
Ste Ab
Quarryville, PA 17566
Phone (717) 786-8896

520 Maple Ave
Ste 3
West Chester, PA 19380
Phone (484) 364-2824

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1881404705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FRONT ST STE 970",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 RIDGE AVE STE 208",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281747",
            "telephone_number": "215-593-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED FOOT AND ANKLE SPECIALISTS OF PA LLC",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A",
        "authorized_official_last_name": "CIACCIO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "LEONARDA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "516-993-8666"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.