COAST TO COAST PODIATRY INC – Podiatrist, NPI 1790896264

COAST TO COAST PODIATRY INC is a healthcare provider. based in Tarpon springs, Florida. specializing in Podiatrist. The organization holds a License No. PO2713 (FL). The NPI Number for COAST TO COAST PODIATRY INC is 1790896264

Main info

Organization
Name
COAST TO COAST PODIATRY INC
NPI
1790896264
Phone
(727) 572-5449
Address
905 E MARTIN LUTHER KING JR DR STE 320
Authorized Official
DR. MICHAEL E DOMIS PRESIDENT DPM
Enumeration Date
31 August 2006
Last Update Date
21 March 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for COAST TO COAST PODIATRY INC

  • 905 E MARTIN LUTHER KING JR DR STE 320

    TARPON SPRINGS, FL 346894853

    Phone: (727) 572-5449

    Fax: (727) 573-2049

    Type: Location

  • 28th Street North, Saint Petersburg, Pinellas County, Florida, 33702, United States

    ST PETERSBURG, FL 337161820

    Phone: (727) 572-5449

    Fax: (727) 573-2049

    Type: Mailing

  • PO BOX 56

    PALM HARBOR, FL 346820056

    Phone: (727) 572-5449

    Fax: (278) 445-4257

    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: 2007-03-19

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20070319000327OClinic/Group PracticeFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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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 34689)

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Reviews

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Frequently asked questions

Can I cross-check COAST TO COAST PODIATRY INC using NPI 1790896264?
NPI 1790896264 belongs to COAST TO COAST PODIATRY INC; compare other details if you need extra assurance.
Active or inactive — what applies to COAST TO COAST PODIATRY INC?
You should see COAST TO COAST PODIATRY INC as active in CMS-hosted NPPES data.
What expertise is attributed to COAST TO COAST PODIATRY INC?
COAST TO COAST PODIATRY INC's specialty line reads Podiatrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for COAST TO COAST PODIATRY INC?
Travel planning: use Tarpon Springs, Florida as the reference point for COAST TO COAST PODIATRY INC, then confirm.
When was this NPI issued?
Enumeration for COAST TO COAST PODIATRY INC is noted as August 31, 2006 where the registry provides it.

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