Organization Active NPI

Northwest Foot & Ankle Associates, P.S.

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
National Provider Identifier
1881860591
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO0000489 Issued in WA
Legal business name
NORTHWEST FOOT & ANKLE ASSOCIATES, P.S.
Practice address
1545 NE 65TH St
Seattle, WA 98115-6800
Phone
(206) 528-0100
Fax
(206) 528-2112
NPI assigned
May 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Cheryl Ann Moore
Title
Billing Manager
Phone
(425) 775-1505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO0000489 WA Primary
Podiatric Clinic/Center 261QP1100X PO00000489 WA

Addresses

Primary practice location

1545 NE 65TH St
Seattle, WA 98115-6800

Mailing address

21229 84TH Ave W
Edmonds, WA 98026-7304
Phone (425) 775-1505

Other names 1

  • Active Foot & Ankle Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070904000382 WA Part B Supplier - Clinic/Group Practice 5395633804 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edmonds, WA; Seattle, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1881860591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21229 84TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267304",
            "telephone_number": "425-775-1505",
            "fax_number": "425-775-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 NE 65TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156800",
            "telephone_number": "206-528-0100",
            "fax_number": "206-528-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FOOT & ANKLE ASSOCIATES, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-02",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "425-775-1505"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO0000489",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "WA",
            "license": "PO00000489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.