FOOT HEALTH CENTERS PC – Foot & Ankle Surgery Podiatrist, NPI 1912930793
Foot & Ankle Surgery Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for FOOT HEALTH CENTERS PC
5400 N Illinois St Ste 104
Fairview Heights, IL 622083563
Phone: (618) 344-4449
Type: Location
122 E ZUPAN ST
MARYVILLE, IL 620622010
Phone: (618) 344-4449
Fax: (618) 344-4551
Type: Mailing
122, East Zupan Street, Maryville, Madison County, Illinois, 62062, United States
MARYVILLE, IL 620622010
Phone: (618) 344-4449
Fax: (618) 344-4551
Type: Location
Post Office Drive Up Box, Foothills Plaza, Sherwood Forest, Maryville, Blount County, East Tennessee, Tennessee, 37802, United States
MARYVILLE, IL 620620340
Phone: (618) 344-4449
Fax: (618) 344-4551
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (739 days ago).
Enrollment records
3
Earliest due date
2024-05-31
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 |
|---|---|---|---|---|
| O20040513000798 | O | Clinic/Group Practice | IL | TBD |
| O20041218000006 | O | Clinic/Group Practice | MO | 2025-06-30 |
| O20100930083814 | O | Physician - Podiatry | IL | 2024-05-31 |
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 62208)
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