NPIMap

Individual provider Active NPI

Andre M Williams, DPM

  • Foot & Ankle Surgery Podiatrist
  • Punta Gorda, FL
National Provider Identifier
1942296959
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3153 Issued in FL
Practice address
352 Milus St
Punta Gorda, FL 33950-4552
Phone
(941) 639-0025
Fax
(941) 374-7271
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3153 FL Primary

Addresses

Primary practice location

352 Milus St
Punta Gorda, FL 33950-4552

Mailing address

PO Box 511269
Punta Gorda, FL 33951-1269
Phone (941) 639-0025

Other identifiers 3

IdentifierTypeStateIssuer
340579600MedicaidFL
POP291370OtherRAILROAD MEDICARE PTAN
65916OtherFLBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000259 FL Practitioner - Podiatry 7416980156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Centers of Charlotte County PAGroup PAC ID 5799718540, 7 clinicians

Practice addresses (Care Compare)

352 Milus St
Punta Gorda, FL 33950-4552
Phone 9416390025203

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as individual
Quality
54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue161
Removal of skin lesions27
Removal of nail tissue761
Removal or shaving of skin growth615
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3153FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Centers of Charlotte County PA Foot & Ankle Surgery CurrentSince Jul 18, 2005 Accepting new patients
Foot & Ankle Centers of Charlotte County PastSince Jul 18, 2005 Accepting new patients

Locations

3406 Tamiami Trl
Unit 1
Port Charlotte, FL 33952
Phone (941) 627-5161

401B E Olympia Ave
Punta Gorda, FL 33950
Phone (941) 639-0025

352 Milus St
Punta Gorda, FL 33950
Phone (941) 639-0025

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1942296959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511269",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339511269",
            "telephone_number": "941-639-0025",
            "fax_number": "941-347-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 MILUS ST",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504552",
            "telephone_number": "941-639-0025",
            "fax_number": "941-374-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDRE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340579600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "POP291370",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "65916",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.