GOLDEN AGE FOOTCARE — NPI 1265667802 (Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine in GOWER, MO)

CMS-1500 Box 24J / 33a • NPI

1265667802

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

213EP1101X (CMS 48)

Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine

Box 32 Service Location & ZIP+4

323 S. 169 HIGHWAY, GOWER, MO, 64454-9116

✓ 9-Digit EDI 837 ZIP+4 (64454-9116)

Practice Phone & Referral Fax

(816) 304-8452

Fax: (816) 468-0742

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1265667802 (GOLDEN AGE FOOTCARE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1265667802` (NPI-2 Organization / Facility)
Provider / Legal Name	GOLDEN AGE FOOTCARE
Plain-English Specialty	Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine NUCC Code: `213EP1101X` (Podiatrist, Primary Podiatric Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	323 S. 169 HIGHWAY, GOWER, MO, 64454-9116
Practice Telephone / Fax	Tel: (816) 304-8452 \| Fax: (816) 468-0742
Administrative Mailing Address	7818 N HULL AVE, KANSAS CITY, MO, 64151-1532
Enumeration & Last Sync	Enumerated: 2009-05-27 \| CMS Record Updated: 2009-05-27
Authorized Official	BOREMY LY (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

323 S. 169 HIGHWAY, GOWER, MO, 64454-9116

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Plain-English Taxonomy & CMS Crosswalk (213EP1101X)

What Does Taxonomy Code 213EP1101X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 213EP1101X translates to:
"Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 48 (Podiatry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Podiatrist, Primary Podiatric Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GOLDEN AGE FOOTCARE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`213EP1101X` — Podiatrist, Primary Podiatric Medicine Plain English: Licensed & Credentialed Podiatric Medicine & Surgery Service Providers — Podiatrist, Primary Podiatric Medicine	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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GOLDEN AGE FOOTCARE (NPI #1265667802)