FITCHBURG PODIATRY LLC
NPI 1629892674
Podiatrist - Foot & Ankle Surgery in Fitchburg, WI
About Fitchburg Podiatry Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FITCHBURG PODIATRY LLC (NPI 1629892674) is a healthcare organization registered as a foot & ankle surgery in Fitchburg, Wisconsin and active in the NPI registry since November 2024. The organization lists Mary Elizabeth Hickner, Podiatrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fitchburg Podiatry 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 Fitchburg Podiatry LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Fitchburg, WI 53711
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 Fitchburg Podiatry LLC's NPI number?
The NPI number for Fitchburg Podiatry LLC is 1629892674. It was assigned to this organization in the NPPES registry on November 14, 2024.
Where is Fitchburg Podiatry LLC located?
Fitchburg Podiatry LLC is located at 2960 Triverton Pike Dr Ste 107, Fitchburg, WI 53711. The listed phone number is (307) 714-2316.
What is Fitchburg Podiatry LLC's specialty?
The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.
Is Fitchburg Podiatry LLC enrolled in Medicare?
Yes. Fitchburg Podiatry LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fitchburg Podiatry LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Fitchburg Podiatry 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 Fitchburg Podiatry LLC was last updated on December 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.
# Fitchburg Podiatry Llc · NPI 1629892674
Foot & Ankle Surgery organization in Fitchburg, Wisconsin. Organization record, active in the CMS NPPES registry since November 14, 2024.
## Identity
- **NPI:** 1629892674 (Entity type: Organization)
- **Enumerated:** November 14, 2024
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Organization subpart:** No
- **Authorized official:** Mary Hickner, PODIATRIST
## Practice location
- **Address:** 2960 TRIVERTON PIKE DR STE 107, Fitchburg, WI 53711-7516
- **Phone:** (307) 714-2316
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 30, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1629892674) · Data from the CMS NPPES public registry.