Provider Demographics
NPI:1003981820
Name:ELEVATE FOOT & ANKLE INC
Entity Type:Organization
Organization Name:ELEVATE FOOT & ANKLE INC
Other - Org Name:NEAL A MARKS OPM INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRETCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-381-3600
Mailing Address - Street 1:4338 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3632
Mailing Address - Country:US
Mailing Address - Phone:216-381-3600
Mailing Address - Fax:216-381-5981
Practice Address - Street 1:4338 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3632
Practice Address - Country:US
Practice Address - Phone:216-381-3600
Practice Address - Fax:216-381-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH826250213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2186085Medicaid
OH9271082Medicare PIN
OH1180940002Medicare NSC