Fayette Foot & Ankle Clinic is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Fayetteville, West Virginia. Their current practice location is
27 Parsons Lane, Fayetteville, West Virginia. You can reach out to their office (for appointments etc.) via phone at
(304) 574-2310.
Fayette Foot & Ankle Clinic is licensed to practice in West Virginia (license number 00282) and it also participates in the medicare program. Fayette Foot & Ankle Clinic
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1184667396.
Healthcare Provider's Profile
| Full Name | Fayette Foot & Ankle Clinic |
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| Type | Facility |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 27 Parsons Lane, Fayetteville, West Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1184667396
- Provider Enumeration Date: 06/14/2006
- Last Update Date: 05/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 5597706440
- Enrollment ID: O20050520000348
Medical Identifiers
Medical identifiers for Fayette Foot & Ankle Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184667396 | NPI | - | NPPES |
| 001721892 | Other | WV | MOUNTAIN STATE BC BS |
| 0099788000 | Medicaid | WV | |
| DD8123 | Other | WV | RAILROAD MEDICARE |
| 223203 | Other | WV | CARELINK |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | 00282 (West Virginia) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 00282 (West Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Fayette Foot & Ankle Clinic acts as a billing entity for following providers:
| Provider Name | Martin Matthew Mrozek |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1437119856
PECOS PAC ID: 2163463027
Enrollment ID: I20050524000784 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fayette Foot & Ankle Clinic is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Fayette Foot & Ankle Clinic
Po Box 825159 Department C,
Philadelphia, PA 19182-5159
Ph: (304) 574-2310 | Fayette Foot & Ankle Clinic
27 Parsons Lane,
Fayetteville, WV 25840-0957
Ph: (304) 574-2310 |
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