Elite Sports Podiatry, PA
NPI 1356743207 · Foot Surgery Podiatrist · Clearwater, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Elite Sports Podiatry, PA is a Foot Surgery Podiatrist organization in Clearwater, FL (NPI 1356743207).
Provider details
- NPI number
- 1356743207
- Entity type
- Organization
- Primary specialty
- Foot Surgery PodiatristPodiatric Medicine & Surgery Service Providers
- Organization subpart
- No
- Authorized official
- Brian Fullem, Medical Doctor/Owner(203) 241-2582
- License
- PO3445 (FL)
Specialties & taxonomies
Podiatric Medicine & Surgery Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-09-23
- Last updated
- 2015-01-07
Frequently asked questions
- What is Elite Sports Podiatry, PA's NPI number?
- Elite Sports Podiatry, PA's National Provider Identifier (NPI) is 1356743207, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Elite Sports Podiatry, PA?
- Elite Sports Podiatry, PA is classified in the NPPES registry as Foot Surgery Podiatrist (Podiatric Medicine & Surgery Service Providers).
- Where is Elite Sports Podiatry, PA located?
- Elite Sports Podiatry, PA's practice location on file with NPPES is 1700 N Mcmullen Booth Rd, Clearwater, FL 33759-2130.
- What is Elite Sports Podiatry, PA's phone number?
- The practice phone number listed in the NPPES registry for Elite Sports Podiatry, PA is (727) 330-7646.
- Does Elite Sports Podiatry, PA accept Medicare?
- Elite Sports Podiatry, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Elite Sports Podiatry, PA?
- The authorized official listed on Elite Sports Podiatry, PA's NPPES record is Brian Fullem, Medical Doctor/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Elite Sports Podiatry, PA's NPI active?
- Yes — Elite Sports Podiatry, PA's NPI (1356743207) is active in the NPPES registry as of the last update on 2015-01-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.