NORTH FULTON PODIATRY – Foot & Ankle Surgery Podiatrist, NPI 1720260409

NORTH FULTON PODIATRY is a healthcare provider. based in Roswell, Georgia. specializing in Foot & Ankle Surgery Podiatrist. The organization holds a License No. 00605 (GA). The NPI Number for NORTH FULTON PODIATRY is 1720260409

Main info

Organization
Name
NORTH FULTON PODIATRY
NPI
1720260409
Phone
(770) 346-7500
Address
1380 UPPER HEMBREE RD
Authorized Official
DR. DEAN P KOSTAKOS OWNER DPM
Enumeration Date
4 December 2007
Last Update Date
21 December 2007
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for NORTH FULTON PODIATRY

  • 1380, Upper Hembree Road, Roswell, Fulton, Georgia, 30009, United States

    ROSWELL, GA 300761146

    Phone: (770) 346-7500

    Fax: (770) 346-8800

    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)

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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-04-30 (771 days ago).

Enrollment records

2

Earliest due date

2024-04-30

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
O20040921000724OClinic/Group PracticeGA2024-04-30
O20100930034182OPhysician - PodiatryGA2026-09-30

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.

Verify on CMS Revalidation Lookup Tool

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 30076)

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Reviews

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Frequently asked questions

What is NORTH FULTON PODIATRY's NPI number?
NORTH FULTON PODIATRY's NPI is 1720260409 — the number used across U.S. healthcare to identify this provider.
Is NORTH FULTON PODIATRY shown as active in public data?
Registry records indicate NORTH FULTON PODIATRY maintains an active NPI.
What expertise is attributed to NORTH FULTON PODIATRY?
NORTH FULTON PODIATRY's specialty line reads Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What locale is associated with NORTH FULTON PODIATRY?
Directory geography for NORTH FULTON PODIATRY centers on Roswell, Georgia.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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