Monroe Podiatry Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MONROE PODIATRY GROUP

Practice address

45 North Ave
Webster, NY 14580-3054

Phone

(585) 872-6520

Fax

(585) 872-6357

NPI assigned

Nov 13, 2006

Last updated

Jul 21, 2022By 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

Mr. Raymond Divasto, DPMNPI 1588629653

Title

Owner

Phone

(585) 872-6520

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 7

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.

• Raymond Divasto, D.P.M.

  • Foot Surgery Podiatrist
  • Webster, NY
  • NPI 1588629653
  Medicare reassignment Care Compare group NPD Authorized official
• Maurice A Palucci, DPM

  • Foot Surgery Podiatrist
  • Webster, NY
  • NPI 1477511558
  Medicare reassignment Care Compare group NPD
• David Michael Miraglia, DDS

  • Dentist
  • Webster, NY
  • NPI 1780707604
  NPD (past)
• Massimo Pietrantoni, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Rochester, NY
  • NPI 1598718017
  NPD (past)
• John W Seaford, MD

  • Internal Medicine Physician
  • Webster, NY
  • NPI 1699731646
  NPD (past)
• Alice Lorraine Kamil, MD

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1407819337
  NPD (past)
• Mirko Roethlisberger, MD

  • Internal Medicine Physician
  • The Villages, FL
  • NPI 1205885480
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023189842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 NORTH AVE",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803054",
            "telephone_number": "585-872-6520",
            "fax_number": "585-872-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NORTH AVE",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145803054",
            "telephone_number": "585-872-6520",
            "fax_number": "585-872-6357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE PODIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DIVASTO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-872-6520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BLUECROSS",
            "identifier": "G0188302590",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Miraglia, RN CCM
• Nancy Ann Mis I, REGISTERED NURSE
• Althea M Mix-Bryan, RN
• Ryenn Lee Moesch, RN, FNP-C
• Sean Mogan, M.D.
• Donte Raelle Monson, LPN
• Randee Montaque, LPN
• Sarah M Montemaro, LCSW-R
• Tricia L Moose, PT
• Mackenzie Moranz, DPT

• Durable Medical Equipment & Medical Supplies in Webster, NY
• Providers in Webster, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.