Organization Active NPI

Comprehensive Foot & Ankle Surgery PLLC

  • Foot & Ankle Surgery Podiatrist
  • Jupiter, FL
National Provider Identifier
1932353372
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2994 Issued in FL
Legal business name
COMPREHENSIVE FOOT & ANKLE SURGERY PLLC
Practice address
550 Heritage Dr Ste 140
Jupiter, FL 33458-3033
Phone
(561) 799-0857
NPI assigned
Nov 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Ms. Lily Pan-Perkins, DPM
Title
Owner
Phone
(561) 799-9581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO2994 FL Primary

Addresses

Primary practice location

550 Heritage Dr Ste 140
Jupiter, FL 33458-3033

Mailing address

550 Heritage Dr Ste 140
Jupiter, FL 33458-3033
Phone (561) 799-0857

Other identifiers 3

IdentifierTypeStateIssuer
65791OtherFLBC/BS
340292400MedicaidFL
65791OtherFLMEDICARE INDIVIDUAL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090422000544 FL Part B Supplier - Clinic/Group Practice 8224185616 Receives reassigned benefits from 2 practitioners
Practice locations: Jupiter, FL
O20100930084320 FL DME Supplier - Physician - Podiatry 8224185616 Practice locations: Jupiter, FL

National Provider Directory

National Provider Directory

Locations

221 Greenwich Cir
Ste 105
Jupiter, FL 33458
Phone (561) 799-9581

Practitioners & affiliated clinicians

Practitioners 3

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": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1932353372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 HERITAGE DR STE 140",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583033",
            "telephone_number": "561-799-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 HERITAGE DR STE 140",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583033",
            "telephone_number": "561-799-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE FOOT & ANKLE SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "PAN-PERKINS",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-799-9581",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "65791",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340292400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "65791",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.