PORT WASHINGTON PODIATRY INC (NPI# 1013953926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013953926 |
| Entity Type | Organization |
| Organization Name | PORT WASHINGTON PODIATRY INC |
| Practice Address |
1317 W Grand Avenue Port Washington Podiatry Port Washington WI 53074 |
| Mailing Address |
2132 Willow Pond Way Grafton WI 53024-9102 |
| Practice Telephone | 2622848800 |
| Practice Fax Number | 2622848861 |
| Mailing Telephone | 2622848800 |
| Mailing Fax Number | 2622848861 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | JEFFREY JOSEPH BONGIORNO (PRESIDENT) |
| Authorized Official Telephone | 2622848800 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 798025 | WI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43268200 | 05 | |
| RR MCR | DB0746 | 01 |
| Street Address |
1317 W GRAND AVENUE PORT WASHINGTON PODIATRY |
| City | PORT WASHINGTON |
| State | WI |
| Zip Code | 53074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447385125 | Joshua E Leute Dds Sc | Dentist | 1317 W Grand Avenue, Port Washington, WI 53074 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962045864 | Heather Kay Brede | Technician | 857 Ashley Avenue, Port Washington, WI 53074 | 2019-10-23 |
| 1780062034 | Amanda Zitzer | Specialist/Technologist | 1037 S Spring Street, Apt 257, Port Washington, WI 53074 | 2015-05-07 |
| 1639507643 | Kelly Mulder | Occupational Therapy Assistant | 138 E Prospect St, Port Washington, WI 53074 | 2013-10-30 |
| 1235310921 | Susan Ann Dobberpuhl | Occupational Therapist | 306 N Sprint St, Port Washington, WI 53074 | 2007-11-21 |
| 1245444736 | Lee B Raffel | Social Worker | 3632 E Norport Drive, Port Washington, WI 53074 | 2007-05-10 |
| 1023143708 | Joshua E Leute | Dentist | 1317 West Grand Avenue, Port Washington, WI 53074 | 2007-02-22 |
| 1578633806 | Robert Andrew Kortsch | Dentist | 457 W Grand Ave, Port Washington, WI 53074 | 2006-11-08 |
| 1538256409 | Daniel P Witkowski | Dentist | 1612 N Wisconsin St, Port Washington, WI 53074 | 2006-10-10 |
| 1477584878 | Francine L Cosner | Obstetrics & Gynecology | 1777 W Grand Avenue, Port Washington, WI 53074 | 2006-07-05 |
| 1588198857 | Stephanie Cooper | Speech-Language Pathologist | 1119 N Wisconsin St, Port Washington, WI 53074 | 2017-04-13 |
| Find all providers in zip 53074 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437256559 | Elba E Chirel | Podiatrist | 3 Beacon Hill Rd, Port Washington, NY 11050-3003 | 2006-09-20 |
| 1184870339 | North Shore Podiatric Foot Care Consultant PC | Podiatrist | 3 Beacon Hill Rd, Port Washington, NY 11050-3003 | 2008-08-07 |
| 1407953599 | Hiram Chirel | Podiatrist | 3 Beacon Hill Rd, Port Washington, NY 11050-3003 | 2006-09-20 |
| 1770599953 | Jeffrey Joseph Bongiorno | Podiatrist | 1317 W Grand Ave, Port Washington, WI 53074-2075 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1912310152 | Wyatt Isaac Wiedenfeld | Podiatrist | 853 S Main St, Oconto Falls, WI 54154-1203 | 2014-06-05 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
| Find all providers with the same taxonomy | ||||
| City | PORT WASHINGTON |
| Zip Code | 53074 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.