Individual provider Active NPI

Nicole Sabrina McCormack, DPM

  • Foot & Ankle Surgery Podiatrist
  • Gettysburg, PA
National Provider Identifier
1942492749
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006159 Issued in PA
Practice address
525 W Middle St
Gettysburg, PA 17325-2418
Phone
(717) 334-1825
Fax
(717) 334-0125
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC006159 PA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 01478 MD

Addresses

Primary practice location

525 W Middle St
Gettysburg, PA 17325-2418

Mailing address

525 W Middle St
Gettysburg, PA 17325-2418
Phone (717) 334-1825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090910000066 MD Practitioner - Podiatry 4587718507
I20190702002591 DC Practitioner - Podiatry 4587718507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laurel Foot and Ankle Center, LLCGroup PAC ID 7113980509, 4 clinicians

Practice addresses (Care Compare)

14440 Cherry Lane CT
Suite 104
Laurel, MD 20707-4946
Phone (301) 953-3668

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue59
Removal of skin lesions1-10
Removal of nail tissue308
Removal or shaving of skin growth58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC006159PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Laurel Foot and Ankle Center, LLC Foot & Ankle Surgery CurrentSince Jul 1, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

14440 Cherry Lane Ct
Ste 104
Laurel, MD 20707
Phone (301) 358-4201

Interoperability endpoints

  • Direct secure messaging: nmccormack801674@direct.umm.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1942492749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W MIDDLE ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173252418",
            "telephone_number": "717-334-1825",
            "fax_number": "717-334-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W MIDDLE ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173252418",
            "telephone_number": "717-334-1825",
            "fax_number": "717-334-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "NICOLE",
        "middle_name": "SABRINA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006159",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

Verify at the official NPI Registry.