Provider Demographics
NPI:1225075070
Name:PODIATRY ASSOCIATES, PA
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES, PA
Other - Org Name:PODIATRY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TROESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-226-9178
Mailing Address - Street 1:8901 W 74TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2204
Mailing Address - Country:US
Mailing Address - Phone:913-432-5052
Mailing Address - Fax:913-432-9990
Practice Address - Street 1:8901 W 74TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2204
Practice Address - Country:US
Practice Address - Phone:913-432-5052
Practice Address - Fax:913-432-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB360000DOtherMEDICARE