| Preferred Podiatry Group Pc | |
|
4950 State Road 16, St Augustine, FL 32092-1613 | |
| (847) 504-5000 | |
| Not Available |
| Full Name | Preferred Podiatry Group Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 4950 State Road 16, St Augustine, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720037138 | NPI | - | NPPES |
| CH4840 | Other | IN | RAILROAD MEDICARE |
| DU2423 | Other | KY | RAILROAD MEDICARE |
| 281333901 | Medicaid | TX | |
| 73780081 | Medicaid | CO | |
| C12116 | Other | IL | RAILROAD MEDICARE |
| DW2427 | Other | CO | RAILROAD MEDICARE |
| 060005901 | Medicaid | IL | |
| 504482407 | Medicaid | MO | |
| CB3726 | Other | WI | RAILROAD MEDICARE |
| 43265500 | Medicaid | WI | |
| 100253080E | Medicaid | IN | |
| 122195500 | Medicaid | FL | |
| Q030004 | Medicaid | TN | |
| 7100257260 | Medicaid | KY | |
| DR6817 | Other | TX | RAILROAD MEDICARE |
| DS6430 | Other | MO | RAILROAD MEDICARE |
| DW2909 | Other | OK | RAILROAD MEDICARE |
| DX1124 | Other | IA | RAILROAD MEDICARE |
| 1720037138 | Medicaid | IA | |
| 200623610A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Jerry M Poole |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710952999 PECOS PAC ID: 0749184935 Enrollment ID: I20040618001124 |
| Provider Name | Bradley Gerard Burkart |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528281862 PECOS PAC ID: 5597715672 Enrollment ID: I20050127000285 |
| Provider Name | Paulet Voigt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164401204 PECOS PAC ID: 3173629813 Enrollment ID: I20070426000290 |
| Provider Name | Roger Zeratsky |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144336066 PECOS PAC ID: 5395829667 Enrollment ID: I20080226000056 |
| Provider Name | Elizabeth S Albanese |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558374975 PECOS PAC ID: 7810053048 Enrollment ID: I20090312000539 |
| Provider Name | Tammy L Galizia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1881860906 PECOS PAC ID: 3476621723 Enrollment ID: I20090319000357 |
| Provider Name | Robert M Bester |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194940106 PECOS PAC ID: 6608923131 Enrollment ID: I20090420000462 |
| Provider Name | Jennifer A Bara |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407180532 PECOS PAC ID: 1850560079 Enrollment ID: I20110804000332 |
| Provider Name | Rebecca L St Louis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1497021034 PECOS PAC ID: 8123275492 Enrollment ID: I20120822000393 |
| Provider Name | Tyler C Yapp |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750644233 PECOS PAC ID: 4587973995 Enrollment ID: I20151027000473 |
| Provider Name | Robyn Winner Paloian |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1255485926 PECOS PAC ID: 5799972626 Enrollment ID: I20160526001475 |
| Provider Name | Jacob Valabov |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1487051371 PECOS PAC ID: 0547551137 Enrollment ID: I20160629002109 |
| Provider Name | Lewis M Wasserman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821284506 PECOS PAC ID: 3577643832 Enrollment ID: I20160824001248 |
| Provider Name | Michael Strangio |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326454380 PECOS PAC ID: 8729324215 Enrollment ID: I20190103001749 |
| Provider Name | Bradley Ross |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588629455 PECOS PAC ID: 9931288222 Enrollment ID: I20200113001781 |
| Provider Name | Shaun M Latshaw |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013402205 PECOS PAC ID: 7517369473 Enrollment ID: I20210714002846 |
| Provider Name | Paul Daniel Hickey |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285128074 PECOS PAC ID: 9234525122 Enrollment ID: I20220331002982 |
| Provider Name | Michael Florie |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700441102 PECOS PAC ID: 3678952884 Enrollment ID: I20221012000123 |
| Provider Name | Alexander San Diego |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053678052 PECOS PAC ID: 6709104482 Enrollment ID: I20221026002936 |
| Provider Name | Taylor Sann |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952612731 PECOS PAC ID: 6608013800 Enrollment ID: I20221215002500 |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Podiatry Group Pc Po Box 772294, Detroit, MI 48277-0917 Ph: (847) 504-5000 | Preferred Podiatry Group Pc 4950 State Road 16, St Augustine, FL 32092-1613 Ph: (847) 504-5000 |
Ryan J Pereira, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1301 Plantation Island Dr S, Ste 203, St Augustine, FL 32080 Phone: 904-461-0821 Fax: 904-461-0823 | |
Ankle & Foot Associates Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 309 Kingsley Lake Dr, # 901, St Augustine, FL 32092 Phone: 904-269-9595 Fax: 904-264-5211 | |
Dr. Nicole C Gortaire, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1690 Us Highway 1 S Ste C, St Augustine, FL 32084 Phone: 904-436-8001 Fax: 904-376-7761 | |
Victoria Jean Camp, DPM, PA Podiatrist Medicare: Medicare Enrolled Practice Location: 1093 A1a Beach Blvd, Pmb 235, St Augustine, FL 32080 Phone: 904-814-4904 | |
Brett Cutler Dpm Pa Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 105 Southpark Blvd, Suite A103, St Augustine, FL 32086 Phone: 904-824-0869 Fax: 904-826-0966 | |
Dr. John M Burns, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1975 Old Moultrie Rd, St Augustine, FL 32086 Phone: 904-825-0046 Fax: 904-826-1586 | |
Meleca Foot And Ankle Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 432 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 517-990-7844 |