NITIE I SROA (D.P.M.) – Podiatrist, NPI 1215236864
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,444 PODIATRY in FL
Provider Addresses for NITIE I SROA (D.P.M.)
1580 SANTA BARBARA BLVD
THE VILLAGES, FL 321596827
Phone: (352) 259-2159
Fax: (352) 259-5731
Type: Mailing
208 COLUMBUS ST STE 200
HICKSVILLE, OH 435261250
Phone: (419) 799-1180
Type: Location
13611 PUFF RD
FORT WAYNE, IN 468458802
Phone: (419) 799-1180
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $118.
Total Amount is formed as General ($118) + Research ($0) + Ownership ($0) = $118.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ConvaTec Inc. ($56).
Total Amount
$118
General + Research + Ownership
Payments
6
Total payment records
General Amount
$118
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ConvaTec Inc. | $56 |
| Averitas Pharma Inc. | $29 |
| MIMEDX Group, Inc. | $19 |
| Bioventus LLC | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-07-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210721001124 | I | Podiatry | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,015 | 289 | $0 |
| A2001 | Innovamatrix ac, per square centimeter | 232 | 12 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 179 | 179 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 150 | 47 | $0 |
| 15275 | Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less | 96 | 21 | $0 |
Insurance plans in this area (ZIP 32159)
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