Individual provider Active NPI

Natalie Mota, DPM

  • Foot & Ankle Surgery Podiatrist
  • O'Fallon, IL
National Provider Identifier
1962817916
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC006548 Issued in PA
Practice address
717 Insight Ave
Suite 100
O'Fallon, IL 62269
Phone
(618) 277-9533
NPI assigned
Jun 29, 2014
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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 016.005755 IL
Foot & Ankle Surgery Podiatrist 213ES0103X SC006548 PA Primary

Addresses

Primary practice location

717 Insight Ave
Suite 100
O'Fallon, IL 62269

Mailing address

717 Insight Ave
Suite 100
O'Fallon, IL 62269
Phone (618) 277-9533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170630000311 IL Practitioner - Podiatry 7911276258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C James Anderson DPM LLCGroup PAC ID 2961652979, 2 clinicians

Practice addresses (Care Compare)

717 Insight Ave
Suite 100
O Fallon, IL 62269-2155
Phone (618) 277-9533

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue454
Removal of skin lesions1-10
Removal of nail tissue1480
Removal or shaving of skin growth503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.005755ILMDFoot & Ankle Surgery Podiatrist
SC006548PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
C James Anderson DPM LLC Foot & Ankle Surgery CurrentSince Oct 11, 2020 Accepting new patients
C James Anderson DPM LLC CurrentSince Aug 1, 2017 Accepting new patients
C James Anderson DPM LLC Foot & Ankle Surgery PastSince Apr 19, 2020 Accepting new patients
Affiliated Ankle and Foot Surgeons Past Accepting new patients

Locations

4600 Memorial Dr
Ste 300
Belleville, IL 62226
Phone (618) 233-3066

1000 Eleven S
Ste 3A
Columbia, IL 62236
Phone (618) 277-9533

717 Insight Ave
Ste 100
O Fallon, IL 62269
Phone (618) 277-9533

Organizations & group practices 4

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 1

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": "1404000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1962817916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 INSIGHT AVE",
            "address_2": "SUITE 100",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-277-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 INSIGHT AVE",
            "address_2": "SUITE 100",
            "city": "O'FALLON",
            "state": "IL",
            "postal_code": "62269",
            "telephone_number": "618-277-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA",
        "first_name": "NATALIE",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-29",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005755",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.