Emmanuel D Lagoutaris, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

PO3053 Issued in FL

Practice address

6209 Brooks Bartram Dr
Jacksonville, FL 32258-5601

Phone

(904) 534-9752

NPI assigned

Nov 9, 2005

Last updated

Mar 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emmanuel Lagoutaris, DPM, LLC

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
  • NPI 1972994770
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1932180676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 COUNTY ROAD 210 W",
            "address_2": "STE 108, PMB 355",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 BROOKS BARTRAM DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585601",
            "telephone_number": "904-534-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGOUTARIS",
        "first_name": "EMMANUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO3053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Lafferty, APRN
• Kayla Laffin
• Andrew H. Lafont, DDS
• Kiaya Laga
• Natalie Rose Lagattuta, DO
• Michelle Vorce Laguens, PA-C
• Kermide Laguerre
• Rachel Lahav, PA
• Carol Devault Lahey, PH.D.
• Deirdre Marie Lahey, D.O.

• Primary Podiatric Medicine Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Podiatric Medicine Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.