Individual provider Active NPI

Timothy Martin Syperek, D.P.M.

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1992723647
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3414 Issued in FL
Practice address
8262 Point Meadows Dr Ste 202
Jacksonville, FL 32256-4700
Phone
(904) 265-0470
Fax
(904) 223-3949
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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 PO3414 FL
Podiatrist 213E00000X PO3414 FL Primary

Addresses

Primary practice location

8262 Point Meadows Dr Ste 202
Jacksonville, FL 32256-4700

Mailing address

705 Wells Rd Ste 300
Orange Park, FL 32073-2982
Phone (904) 282-6331

Other identifiers 1

IdentifierTypeStateIssuer
006342200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100322000660 FL Practitioner - Podiatry 1153497177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Physicians Group Services PAGroup PAC ID 1254238579, 91 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1906 Southside Blvd
Jacksonville, FL 32216-1930
Phone (904) 724-3083

421 Kingsley Ave
Orange Park, FL 32073-4898

PO Box
Melrose, FL 32666-1099

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue462
Removal of skin lesions1-10
Removal of nail tissue591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PO3414FLMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Group Services PA Foot & Ankle Surgery CurrentSince Aug 1, 2012 Accepting new patients
Physicians Group Services PA Podiatrist CurrentSince Aug 1, 2012 Accepting new patients
Physicians Group Services PA Foot & Ankle Surgery Past Accepting new patients

Locations

1906 Southside Blvd
Jacksonville, FL 32216
Phone (904) 724-3083

7855 Argyle Forest Blvd
Ste 101
Jacksonville, FL 32244

8262 Point Meadows Dr
Jacksonville, FL 32256
Phone (904) 265-4320

8262 Point Meadows Dr
Ste 202
Jacksonville, FL 32256
Phone (904) 217-5810

14011 Beach Blvd
Ste 220
Jacksonville Beach, FL 32250
Phone (904) 265-0180

1909 Beach Blvd
Ste 102
Jax Bch, FL 32250
Phone (904) 246-2752

705 Wells Rd
#300
Orange Park, FL 32073
Phone (904) 282-5474

421 Kingsley Ave
Ste 400
Orange Park, FL 32073
Phone (904) 204-5000

Interoperability endpoints

  • Direct secure messaging: timothy.syperek.1@25110.direct.athenahealth.com

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 and National Provider Directory roles.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1992723647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8262 POINT MEADOWS DR STE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564700",
            "telephone_number": "904-265-0470",
            "fax_number": "904-223-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYPEREK",
        "first_name": "TIMOTHY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3414",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006342200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.