Podiatric Medical Associates PC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PODIATRIC MEDICAL ASSOCIATES PC

Practice address

6289 Central Ave
Portage, IN 46368-3725

Phone

(219) 763-2008

Fax

(219) 762-2291

NPI assigned

Mar 19, 2007

Last updated

Dec 18, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen K Grandfield, DPM

Title

President

Phone

(219) 763-2008

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

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

• Podiatric Medical Associates PC

  • Podiatrist
  • Merrillville, IN
  • NPI 1134237639

  0941100283

  Same PAC ID
• Podiatric Medical Associates PC

  • Foot & Ankle Surgery Podiatrist
  • La Porte, IN
  • NPI 1427172014

  0941100283

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Podiatric Medical Associates PC

  • Podiatrist
  • Merrillville, IN
  • NPI 1134237639

  O20040112000205

  Same enrollment
• Podiatric Medical Associates PC

  • Foot & Ankle Surgery Podiatrist
  • La Porte, IN
  • NPI 1275926347

  O20040112000205

  Same enrollment
• Podiatric Medical Associates PC

  • Foot & Ankle Surgery Podiatrist
  • La Porte, IN
  • NPI 1427172014

  O20040112000205

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jesse Murphy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Merrillville, IN
  • NPI 1215223235
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1982728200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6289 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683725",
            "telephone_number": "219-763-2008",
            "fax_number": "219-762-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6289 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683725",
            "telephone_number": "219-763-2008",
            "fax_number": "219-762-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRIC MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "GRANDFIELD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-763-2008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100907960",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "492470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200326020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Phillips, PTA
• Kaitlyn Pickering, RBT
• Heather Marie Piehl, FNP-BC
• Lisa Y. Pina-Awosika, DDS
• Kristin Renee Piunti
• Paul C Pollachek, RN,BS
• Kelly Pollard, AGACNP
• Connie Ponce de Leon
• Cara Anne Popenhagen, R.N.
• Portage Health Center Occupational Health

• Podiatrist in Portage, IN
• Providers in Portage, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.