Podiatric Physicians and Surgeons P.S.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P0OOO177 Issued in WA

Legal business name

PODIATRIC PHYSICIANS AND SURGEONS P.S.

Doing business as

dr. ronald krivosha

Practice address

11711 NE 12TH St
Suite 1B
Bellevue, WA 98005

Phone

(425) 453-1598

Fax

(425) 450-0029

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ronald S Krivosha, DPM

Title

Doctor of Podiatric Medicine

Phone

(425) 453-1598

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• dr. ronald krivosha Doing business as

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1952480899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "SUITE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-453-1498",
            "fax_number": "425-450-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "SUITE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-453-1598",
            "fax_number": "425-450-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRIC PHYSICIANS AND SURGEONS P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "KRIVOSHA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "425-453-1598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "P0OOO177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477405",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010701",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDURSTRY",
            "identifier": "0059835",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dr. ronald krivosha",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Podiatrist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.