st johns foot and ankle specialists, LLC – Foot & Ankle Surgery Podiatrist, NPI 1457839839
Foot & Ankle Surgery Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for st johns foot and ankle specialists, LLC
9 Pine Cone Dr Ste 101
Palm Coast, FL 321378683
Phone: (904) 436-8001
Fax: (904) 376-7761
Type: Location
320 Zeagler Dr Ste B
Palatka, FL 321776851
Phone: (904) 436-8001
Fax: (904) 376-7761
Type: Location
1690 US HIGHWAY 1 S STE C
SAINT AUGUSTINE, FL 320846024
Phone: (904) 436-8001
Fax: (904) 377-6776
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2020-05-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (587 days ago).
Enrollment records
2
Earliest due date
2024-10-31
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 |
|---|---|---|---|---|
| O20190228000450 | O | Clinic/Group Practice | FL | 2024-10-31 |
| O20200529000454 | O | Physician - Podiatry | FL | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32137)
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