LAKE ERIE PODIATRY, LLC (NPI# 1922164409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922164409 |
| Entity Type | Organization |
| Organization Name | LAKE ERIE PODIATRY, LLC |
| Practice Address |
3910 Caughey Rd Ste 130 Erie PA 16506 |
| Mailing Address |
3910 Caughey Rd Ste 130 Erie PA 16506-4097 |
| Practice Telephone | 8148333668 |
| Practice Fax Number | 8883296120 |
| Mailing Telephone | 8148333668 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2018-08-10 |
| Authorized Official Name | DR. MICHAEL A RUIZ (MANAGER) |
| Authorized Official Telephone | 8148333668 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
SC004630L | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE RRB | 480035188 | 01 |
| PA | 0019415170002 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1444 W 38th St, Suite A, Erie, PA 165082346 | 8148665141 |
| Street Address |
3910 CAUGHEY RD STE 130 |
| City | ERIE |
| State | PA |
| Zip Code | 16506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582838 | Casey Smith | Behavioral Analyst | 4950 W 23rd Street, Suite 1, Erie, PA 16506 | 2019-08-09 |
| 1962916155 | Joseph Michael Moon | Chiropractor | 2921 W 26th St, Erie, PA 16506 | 2017-11-27 |
| 1053851550 | Lake Erie Music Therapy LLC | Music Therapist | 5672 Culpepper Dr., Erie, PA 16506 | 2017-03-02 |
| 1295152700 | Gabrielle Carr | Counselor | 2420 West 23rd St, Erie, PA 16506 | 2014-03-21 |
| 1407296973 | Carolyn Danner-bliss Pediatric Dietitian Services, LLC | Dietitian, Registered | 5105 Coventry Drive, Erie, PA 16506 | 2013-06-28 |
| 1962847772 | Philip J Dunn | Internal Medicine | 3615 Woodhaven Dr, Erie, PA 16506 | 2013-05-07 |
| 1619236684 | Joseph S. Serafini | Hearing Instrument Specialist | 2930 Mckee Rd, Erie, PA 16506 | 2012-05-11 |
| 1063788313 | Tatiana V Khochay | Registered Nurse | 2801 Burgundy Dr., Erie, PA 16506 | 2012-03-30 |
| 1699051318 | Krystyna Teresa Wozniak | Licensed Practical Nurse | 3912 East Boardwalk Place, Erie, PA 16506 | 2011-10-26 |
| 1033436324 | Alexis Jean Mustin | Social Worker | 3210 West 32nd Street, Erie, PA 16506 | 2010-04-26 |
| Find all providers in zip 16506 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104331461 | Saint Vincent Medical Education and Research Inst. Inc. | Podiatrist | 5473 Village Common Dr Ste 202, Erie, PA 16506-4961 | 2017-12-08 |
| 1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
| 1396981494 | Foot & Ankle Innovations, P.C. | Podiatrist | 2960 Persimmon Dr, Erie, PA 16509-8042 | 2008-12-21 |
| 1114105210 | Ankle and Foot Clinic of Erie PC | Podiatrist | 3737 W 26th St, Erie, PA 16506-2038 | 2008-01-31 |
| 1407881162 | Joseph M Difranco | Podiatrist | 145 W 23rd St Ste 302a, Erie, PA 16502-2858 | 2006-07-11 |
| 1730146150 | Brian E Mussett | Podiatrist | 3737 West 26th Street, Erie, PA 16506 | 2006-04-28 |
| 1255395224 | Daniel J Olson | Podiatrist | 3850 Walker Blvd, Erie, PA 16509-1627 | 2006-04-14 |
| 1568442077 | Douglas Martin Nelson | Podiatrist | 1326 Peninsula Dr, Erie, PA 16505-4235 | 2006-01-19 |
| 1891798435 | Jay C Moritz | Podiatrist | 3330 Peach St Ste 107, Erie, PA 16508-2771 | 2005-05-27 |
| 1538787221 | Lex Herwen Barte I | Podiatrist | 5515 Peach St, Erie, PA 16509-2603 | 2020-07-08 |
| Find all providers in ERIE | ||||
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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.