Metroplus Podiatry Care PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N006502-1 Issued in NY

Legal business name

METROPLUS PODIATRY CARE PC

Practice address

2519 30TH Dr Ste 1L
Astoria, NY 11102-2701

Phone

(646) 421-9356

NPI assigned

Jan 11, 2018

Last updated

Dec 31, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mamdou Abousamra, DPMNPI 1700104056

Title

Owner/Podiatrist

Phone

(646) 421-9356

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mamdou Abousamra, DPM

  • Foot & Ankle Surgery Podiatrist
  • Astoria, NY
  • NPI 1700104056
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1003324179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 30TH DR STE 1L",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022701",
            "telephone_number": "646-421-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 30TH DR STE 1L",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022701",
            "telephone_number": "646-421-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPLUS PODIATRY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-11",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "ABOUSAMRA",
        "authorized_official_first_name": "MAMDOU",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "646-421-9356",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006502-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Astoria, NY
• Providers in Astoria, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.