CRYSTAL LAKE FOOT & ANKLE CENTER LLC
NPI 1649986795
Podiatrist - Foot & Ankle Surgery in Crystal Lake, IL
About Crystal Lake Foot & Ankle Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CRYSTAL LAKE FOOT & ANKLE CENTER LLC (NPI 1649986795) is a healthcare organization registered as a foot & ankle surgery in Crystal Lake, Illinois and active in the NPI registry since January 2023. The organization lists Paul Potach, Owner, 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)
Crystal Lake Foot & Ankle Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Crystal Lake Foot & Ankle Center LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
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 Crystal Lake Foot & Ankle Center LLC's NPI number?
The NPI number for Crystal Lake Foot & Ankle Center LLC is 1649986795. It was assigned to this organization in the NPPES registry on January 23, 2023.
Where is Crystal Lake Foot & Ankle Center LLC located?
Crystal Lake Foot & Ankle Center LLC is located at 39 S Virginia St, Crystal Lake, IL 60014. The listed phone number is (815) 477-9221.
What is Crystal Lake 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 Crystal Lake Foot & Ankle Center LLC enrolled in Medicare?
Yes. Crystal Lake Foot & Ankle Center LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Crystal Lake Foot & Ankle Center LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Podiatry, reassign their Medicare billing to Crystal Lake 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 Crystal Lake Foot & Ankle Center LLC was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Crystal Lake Foot & Ankle Center Llc · NPI 1649986795
Foot & Ankle Surgery organization in Crystal Lake, Illinois. Organization record, active in the CMS NPPES registry since January 23, 2023.
## Identity
- **NPI:** 1649986795 (Entity type: Organization)
- **Enumerated:** January 23, 2023
- **Primary specialty:** Podiatrist - Foot & Ankle Surgery · taxonomy 213ES0103X
- **Organization subpart:** No
- **Authorized official:** Paul Potach, OWNER
## Practice location
- **Address:** 39 S VIRGINIA ST, Crystal Lake, IL 60014-5826
- **Phone:** (815) 477-9221
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Podiatry) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 16, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1649986795) · Data from the CMS NPPES public registry.