Organization Active NPI

Bruce & Marilyn Vinokur Foot Care Group LLC

  • Foot Surgery Podiatrist
  • Waterbury, CT
National Provider Identifier
1003008343
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
00214 Issued in CT
Legal business name
BRUCE & MARILYN VINOKUR FOOT CARE GROUP LLC
Practice address
1211 W Main St
Waterbury, CT 06708-3106
Phone
(203) 755-2050
Fax
(203) 755-0131
NPI assigned
Aug 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marilyn M. Vinokur, D.P.M.NPI 1164471561
Title
Podiatrist
Phone
(203) 755-2050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 00214 CT Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1211 W Main St
Waterbury, CT 06708-3106

Mailing address

1211 West Main Street
Waterbury, CT 06708-2762
Phone (203) 755-2050

Other identifiers 1

IdentifierTypeStateIssuer
004068821MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100922000895 CT Part B Supplier - Clinic/Group Practice 4486770864 Receives reassigned benefits from 3 practitioners
Practice locations: Seymour, CT; Waterbury, CT
O20100930034831 CT DME Supplier - Physician - Podiatry 6709091010 Practice locations: Waterbury, CT

National Provider Directory

National Provider Directory

Locations

17 Westerman Ave
Seymour, CT 06483
Phone (203) 590-7569

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1003008343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 WEST MAIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082762",
            "telephone_number": "203-755-2050",
            "fax_number": "203-755-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083106",
            "telephone_number": "203-755-2050",
            "fax_number": "203-755-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE & MARILYN VINOKUR FOOT CARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "VINOKUR",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "203-755-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "00214",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004068821",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.