STACIE DYAN ANDERSON (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1790079812
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
953 PODIATRY in OH
Provider Addresses for STACIE DYAN ANDERSON (DPM)
5625 RIDGE RD
PARMA, OH 441292633
Phone: (440) 884-4100
Fax: (440) 884-4742
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $54.
Total Amount is formed as General ($54) + Research ($0) + Ownership ($0) = $54.
Last reported payment date: 2024-04-02 • Largest payer in this snapshot: TREACE MEDICAL CONCEPTS, INC. ($30).
Total Amount
$54
General + Research + Ownership
Payments
2
Total payment records
General Amount
$54
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| TREACE MEDICAL CONCEPTS, INC. | $30 |
| Davol Inc. | $24 |
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: 2012-06-29
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 |
|---|---|---|---|---|
| I20120629000405 | 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 |
|---|---|---|---|---|
| 11721 | Removal of fingernails or toenails, 6 or more nails | 1,275 | 397 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 118 | 80 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 68 | 48 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 55 | 55 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 45 | 45 | $0 |
Insurance plans in this area (ZIP 44129)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PODIATRY | OH | 73630 | X-ray of foot, minimum of 3 views | 21 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | OH | |
| P O D I A T R Y | OH | |
| P O D I A T R Y | OH |
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