Active NPI
Kendall Stewart, DPM
- Foot & Ankle Surgery Podiatrist
- Brooklyn, NY
National Provider Identifier
1023289337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- N003320-1
- Practice address
- 4016 Church Ave
Brooklyn, NY 11203-2917 - Phone
- (718) 284-3982
- Fax
- (718) 284-2881
- NPI assigned
- Mar 13, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | N003320-1 | NY | Primary |
Addresses
Primary practice location
4016 Church Ave
Brooklyn, NY 11203-2917
Mailing address
4016 Church Ave
Brooklyn, NY 11203-2917
Phone (718) 284-3982
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00645381 | Medicaid | NY | |
| 0083119 | Other | NY | GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N003320-1 | NY | MD | Foot & Ankle Surgery Podiatrist |
| 003320 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369699200000",
"number": "1023289337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4016 CHURCH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032917",
"telephone_number": "718-284-3982",
"fax_number": "718-284-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4016 CHURCH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112032917",
"telephone_number": "718-284-3982",
"fax_number": "718-284-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KENDALL",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-13",
"last_updated": "2013-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "N003320-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00645381",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0083119",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.