Step Up Podiatry Professional Corporation

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E34090 Issued in CA

Legal business name

STEP UP PODIATRY PROFESSIONAL CORPORATION

Practice address

1350 Medical Center Dr
Ste B
Rohnert Park, CA 94928-2932

Phone

(707) 586-9300

NPI assigned

Jul 20, 2015

Last updated

Jul 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Michael Fitzgerald, DPMNPI 1841231834

Title

Owner

Phone

(707) 586-9300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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.

• Ameha Teklu Joba, DPM

  • Foot & Ankle Surgery Podiatrist
  • Rohnert Park, CA
  • NPI 1043506140
  Medicare reassignment
• Thomas M Fitzgerald, DPM

  • Primary Podiatric Medicine Podiatrist
  • Rohnert Park, CA
  • NPI 1841231834
  Authorized official Same address or phone
• Ralph P. Hoyal, DPM

  • Podiatrist
  • Santa Rosa, CA
  • NPI 1265498828
  NPD (past)
• Larry Alan Smith, DPM

  • Podiatrist
  • Santa Rosa, CA
  • NPI 1609979822
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1902280928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MEDICAL CENTER DR",
            "address_2": "STE B",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282932",
            "telephone_number": "707-586-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MEDICAL CENTER DR",
            "address_2": "STE B",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282932",
            "telephone_number": "707-586-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEP UP PODIATRY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-586-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E34090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Joseph Health Northern California, LLC (Santa Rosa Memorial Hospital)
• Megan Stafford, PSY.D.
• Jessica Jay Stanton, M.D.
• Tyler Reed Starley, DDS
• Donald R. Steffy, DDS
• Maya Ann Stephen
• Madelyn Stephenson
• Michael Stern
• Danielle Christine Stewart
• Nancy Marie Straub

• Foot & Ankle Surgery Podiatrist in Rohnert Park, CA
• Providers in Rohnert Park, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.