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PENNDOC FOOT & ANKLE CENTER, LLC
NPI 1407040025
Podiatrist - Foot & Ankle Surgery in Bradford, PA

Active since August 28, 2007
133 MILL ST, BRADFORD, PA 16701(814) 362-3668(814) 362-0540 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 22, 2020, Aug 20, 2020 (2 updates tracked since 2020).

About Penndoc Foot & Ankle Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNDOC FOOT & ANKLE CENTER, LLC (NPI 1407040025) is a healthcare organization registered as a foot & ankle surgery in Bradford, Pennsylvania and active in the NPI registry since August 2007. The organization lists Holly Foot Eakin, Office Biller, as its authorized official.

NPPES Registry Identity

NPI1407040025
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NamePENNDOC FOOT & ANKLE CENTER, LLC
Location Address133 MILL STBradford, PA 16701-1408
Mailing AddressPo Box 40Bradford, PA 16701-0040 · (814) 362-3668 · Fax (814) 362-0540
Phone(814) 362-3668
Fax(814) 362-0540
Organization SubpartNo
Authorized OfficialHolly Foot EakinOffice Biller · (181) 436-2366
Enumeration DateAugust 28, 2007
Last NPPES UpdateDecember 22, 20202 updates tracked since enumeration
NPPES CertifiedDecember 22, 2020
✔ NPI 1407040025 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in PA · SC003540L
133 MILL ST, Bradford, PA 16701
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Other Identifiers 1

Medicaid0012260110001PA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Penndoc Foot & Ankle Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Penndoc Foot & Ankle Center, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gary Smith, DPM
Podiatry
NPI 1457368862
133 MILL ST
Bradford, PA 16701
(814) 362-3668
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Penndoc Foot & Ankle Center, LLC's NPI number?

The NPI number for Penndoc Foot & Ankle Center, LLC is 1407040025. It was assigned to this organization in the NPPES registry on August 28, 2007.

Where is Penndoc Foot & Ankle Center, LLC located?

Penndoc Foot & Ankle Center, LLC is located at 133 Mill St, Bradford, PA 16701. The listed phone number is (814) 362-3668.

What is Penndoc Foot & Ankle Center, LLC's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Penndoc Foot & Ankle Center, LLC enrolled in Medicare?

Yes. Penndoc Foot & Ankle Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Penndoc Foot & Ankle Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Penndoc Foot & Ankle Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Penndoc Foot & Ankle Center, LLC was last updated on December 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.