Organization Active NPI

Boca Podiatry Group, P.a.

  • Foot Surgery Podiatrist
  • Boca Raton, FL
National Provider Identifier
1902968860
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PO2245 Issued in FL
Legal business name
BOCA PODIATRY GROUP, P.A.
Practice address
1353 W Palmetto Park Rd
Boca Raton, FL 33486-3303
Phone
(561) 750-3060
Fax
(561) 750-3011
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Dr. Paul Alan Sommer, DPMNPI 1003818543
Title
President
Phone
(561) 750-3060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X PO2245 FL Primary

Addresses

Primary practice location

1353 W Palmetto Park Rd
Boca Raton, FL 33486-3303

Mailing address

1353 W Palmetto Park Rd
Boca Raton, FL 33486-3303
Phone (561) 750-3060

Other identifiers 1

IdentifierTypeStateIssuer
390091600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930031181 FL DME Supplier - Physician - Podiatry 3072632074 Practice locations: Boca Raton, FL
O20111219000293 FL Part B Supplier - Clinic/Group Practice 3072632074 Receives reassigned benefits from 1 practitioner
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Locations

1353 W Palmetto Park Rd
Boca Raton, FL 33486
Phone (561) 750-3060

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1902968860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 W PALMETTO PARK RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334863303",
            "telephone_number": "561-750-3060",
            "fax_number": "561-750-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 W PALMETTO PARK RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334863303",
            "telephone_number": "561-750-3060",
            "fax_number": "561-750-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA PODIATRY GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "SOMMER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-750-3060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO2245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390091600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.