ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC – Foot & Ankle Surgery Podiatrist, NPI 1801568431

ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC is a healthcare provider. based in Saint johns, Florida. specializing in Foot & Ankle Surgery Podiatrist. The NPI Number for ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC is 1801568431

Main info

Organization
Name
ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC
NPI
1801568431
Phone
(315) 382-5910
Address
230 MORNING MIST LN
Authorized Official
DR. DANIEL A BLACK OWNER OF TIN/PRACTICE DPM
Enumeration Date
1 October 2021
Last Update Date
1 October 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:4State licenses:0Digital endpointsOther names

Provider Addresses for ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC

  • 230 MORNING MIST LN

    SAINT JOHNS, FL 322598511

    Phone: (315) 382-5910

    Type: Mailing

  • 113 NATURE WALK PWKY

    STE. 105

    SAINT AUGUSTINE, FL 32092

    Phone: (315) 382-5910

    Type: Location

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: 2021-11-19

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
O20211119000110OClinic/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 32259)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC?
ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC — NPI 1801568431 — is the standard way to identify this listing.
Does the file indicate ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC is practicing under active NPI?
Directory data currently reports ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC as active.
What is ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC's specialty?
The listing groups ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC with Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
Where is ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC based?
ST. JOHNS PODIATRY & WOUND CARE SPECIALISTS LLC is tied to Saint Johns, Florida in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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