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PORT WASHINGTON PODIATRY INC NPI 1013953926


NPI Information

NPI: 1013953926
Provider Name: PORT WASHINGTON PODIATRY INC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1317 W GRAND AVENUE
PORT WASHINGTON PODIATRY
PORT WASHINGTON, WI
ZIP 53074
Phone: (262) 284-8800
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PORT WASHINGTON PODIATRY INC is a podiatrist in Port Washington, WI. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. PORT WASHINGTON PODIATRY INC NPI is 1013953926. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1317 W GRAND AVENUE
PORT WASHINGTON PODIATRY
PORT WASHINGTON, WI
ZIP 53074
Phone: (262) 284-8800
Fax: (262) 284-8861

The provider's authorized official is Jeffrey Joseph Bongiorno .
The authorized official title is President and has the following contact phone number (262) 284-8800.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist798025WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DB0746OTHERRR MCR
2U77241MEDICARE UPIN
343268200MEDICAIDWISCONSIN
4=========014OTHERBLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.