PLYMOUTH PODIATRY PC – Podiatrist, NPI 1003309444
Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PLYMOUTH PODIATRY PC
116 COURT ST STE 3
PLYMOUTH, MA 023608710
Phone: (508) 747-1973
Fax: (508) 747-5392
Type: Mailing
400 West St Ste 2
Brockton, MA 023014170
Phone: (508) 747-1973
Fax: (508) 747-5392
Type: Location
68 Camp St Ste 2
Hyannis, MA 026013048
Phone: (774) 470-4507
Fax: (774) 810-7189
Type: Location
675 Paramount Dr Ste 204
Raynham, MA 027675416
Phone: (508) 936-3028
Fax: (508) 828-1268
Type: Location
257 1/2, Sandwich Street, Jabez Corner, Plymouth, Plymouth County, Massachusetts, 02360, United States
PLYMOUTH, MA 023602400
Phone: (508) 747-1983
Fax: (508) 747-5392
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: 2019-06-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (620 days ago).
Enrollment records
2
Earliest due date
2024-09-30
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 |
|---|---|---|---|---|
| O20190506000335 | O | Physician - Podiatry | MA | TBD |
| O20190621001375 | O | Clinic/Group Practice | MA | 2024-09-30 |
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.
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 02360)
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