Ankle And Foot Centers Of Missouri P.c. is a medicare enrolled "Clinical Medical Laboratory" provider in Gladstone, Missouri. Their current practice location is
407 Ne 76th Ter, Gladstone, Missouri. You can reach out to their office (for appointments etc.) via phone at
(816) 436-7900.
Ankle And Foot Centers Of Missouri P.c. is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ankle And Foot Centers Of Missouri P.c.
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 1790714491.
Healthcare Provider's Profile
| Full Name | Ankle And Foot Centers Of Missouri P.c. |
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| Type | Facility |
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| Speciality | Clinical Medical Laboratory |
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| Location | 407 Ne 76th Ter, Gladstone, Missouri |
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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: 1790714491
- Provider Enumeration Date: 07/03/2006
- Last Update Date: 03/29/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214934124
- Enrollment ID: O20061106000455
Medical Identifiers
Medical identifiers for Ankle And Foot Centers Of Missouri P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790714491 | NPI | - | NPPES |
| 505265009 | Medicaid | MO | |
| 365265016 | Medicaid | MO | |
| CB6768 | Other | | RAILROAD AHN |
| CB6767 | Other | | RAILROAD |
| 365265008 | Medicaid | MO | |
| 505265017 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | 000747 (Missouri) | Secondary |
| 213E00000X | Podiatrist | (* (Not Available)) | Secondary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ankle And Foot Centers Of Missouri P.c. acts as a billing entity for following providers:
| Provider Name | Akilis M Theoharidis |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1912933474
PECOS PAC ID: 2860495447
Enrollment ID: I20060821000527 |
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| Provider Name | Elijah L Davis |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1265545966
PECOS PAC ID: 9931275955
Enrollment ID: I20080827000476 |
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| Provider Name | Tanner Coleman |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1780156687
PECOS PAC ID: 7911324819
Enrollment ID: I20200824001891 |
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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. Ankle And Foot Centers Of Missouri P.c. 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 |
|---|
Ankle And Foot Centers Of Missouri P.c.
407 Ne 76th Ter,
Gladstone, MO 64118-1708
Ph: (816) 436-7900 | Ankle And Foot Centers Of Missouri P.c.
407 Ne 76th Ter,
Gladstone, MO 64118-1708
Ph: (816) 436-7900 |
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