Organization Active NPI

Foundation Foot and Ankle Center LLC

  • Podiatrist
  • Naperville, IL
National Provider Identifier
1962092437
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOUNDATION FOOT AND ANKLE CENTER LLC
Practice address
1012 95TH St Ste 12
Naperville, IL 60564-5040
Phone
(504) 410-4702
NPI assigned
Jan 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Anna Yang, DPMNPI 1659754000
Title
Owner
Phone
(504) 410-4702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1012 95TH St Ste 12
Naperville, IL 60564-5040

Mailing address

1012 95TH St Ste 12
Naperville, IL 60564-5040
Phone (630) 635-5889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210615002053 IL Part B Supplier - Clinic/Group Practice 1456751379 Receives reassigned benefits from 1 practitioner
Practice locations: Naperville, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Foundation Foot and Ankle Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1012 95th St
Ste 12
Naperville, IL 60564
Phone (630) 355-1102

Practitioners & affiliated clinicians

Practitioners 1

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": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1962092437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 95TH ST STE 12",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645040",
            "telephone_number": "630-635-5889",
            "fax_number": "630-570-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 95TH ST STE 12",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645040",
            "telephone_number": "504-410-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-410-4702",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.