Active NPI
Richard D Koenig, DPM
- Foot & Ankle Surgery Podiatrist
- Merritt Island, FL
National Provider Identifier
1881739258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PO2725
- Practice address
- 280 N Sykes Creek Pkwy
Merritt Island, FL 32953-3491 - Phone
- (321) 452-5133
- Fax
- (321) 452-5747
- NPI assigned
- Feb 21, 2007
- Last updated
- Aug 14, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO2725 | FL | Primary |
Addresses
Primary practice location
280 N Sykes Creek Pkwy
Merritt Island, FL 32953-3491
Mailing address
PO Box 541637
#B
Merritt Island, FL 32954-1637
Phone (321) 452-5133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brevard Healthworx Inc | Foot & Ankle Surgery | Past | Accepting new patients |
| Richard D. Koenig, DPM, Facfas | Foot & Ankle Surgery | Past | Accepting new patients |
| Mobile Health Inc. | Past | Accepting new patients |
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.
-
dba Island Podiatry Associates
- Foot & Ankle Surgery Podiatrist
- Merritt Island, FL
- NPI 1841423035
-
- Foot & Ankle Surgery Podiatrist
- Boynton Beach, FL
- NPI 1699312256
-
dba Brevard Podiatry Group
- Foot & Ankle Surgery Podiatrist
- Merritt Island, FL
- NPI 1477590362
-
- Podiatrist
- St Petersburg, FL
- NPI 1801841887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344902400000",
"number": "1881739258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 541637",
"address_2": "#B",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329541637",
"telephone_number": "321-452-5133",
"fax_number": "321-452-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 N SYKES CREEK PKWY",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329533491",
"telephone_number": "321-452-5133",
"fax_number": "321-452-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "RICHARD",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2012-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "PO2725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.