Individual provider Active NPI

Ronald F Iannacone, DPM

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1013980994
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
004104 Issued in NY
Practice address
6910 Avenue U
Suite la
Brooklyn, NY 11234-6129
Phone
(718) 968-8080
Fax
(718) 968-8088
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 004104 NY Primary

Addresses

Primary practice location

6910 Avenue U
Suite la
Brooklyn, NY 11234-6129

Mailing address

6910 Avenue U
Suite la
Brooklyn, NY 11234-6129
Phone (718) 968-8080

Other identifiers 1

IdentifierTypeStateIssuer
01020057MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000176 NY Practitioner - Podiatry 4284824541 Practice locations: Northport, NY; Woodside, NY; Suite la, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

482 Main St
Northport, NY 11768-1953
Phone (631) 754-7000

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue2172
Removal or shaving of skin growth305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004104NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Boulevard Extended Care Facility Management LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1013980994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 AVENUE U",
            "address_2": "SUITE LA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346129",
            "telephone_number": "718-968-8080",
            "fax_number": "718-968-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 AVENUE U",
            "address_2": "SUITE LA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346129",
            "telephone_number": "718-968-8080",
            "fax_number": "718-968-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNACONE",
        "first_name": "RONALD",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "004104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01020057",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.