NPIMap

Organization Active NPI

Advanced Podiatry of Huntington PLLC

  • Foot Surgery Podiatrist
  • Huntington, NY
National Provider Identifier
1023299096
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
ADVANCED PODIATRY OF HUNTINGTON PLLC
Practice address
76 E Main St
Suite 3
Huntington, NY 11743-2837
Phone
(631) 427-3678
Fax
(631) 427-5595
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Dr. Pedram A Hendizadeh, DPMNPI 1780786517
Title
Partner
Phone
(631) 427-3678

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 Primary
Durable Medical Equipment & Medical Supplies 332B00000X N005950-1 NY

Addresses

Primary practice location

76 E Main St
Suite 3
Huntington, NY 11743-2837

Mailing address

76 E Main St
Suite 3
Huntington, NY 11743-2837
Phone (631) 427-3678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071227000065 NY Part B Supplier - Clinic/Group Practice 5890885164 Receives reassigned benefits from 8 practitioners
Practice locations: Huntington, NY; Ronkonkoma, NY
O20100930100172 NY DME Supplier - Physician - Podiatry 5890885164 Practice locations: Huntington, NY

National Provider Directory

National Provider Directory

Locations

76 E Main St
Ste 3
Huntington, NY 11743
Phone (631) 427-3678

181 Main St
Huntington, NY 11743
Phone (631) 335-3584

Practitioners & affiliated clinicians

Practitioners 8

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": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1023299096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432837",
            "telephone_number": "631-427-3678",
            "fax_number": "631-427-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432837",
            "telephone_number": "631-427-3678",
            "fax_number": "631-427-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PODIATRY OF HUNTINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "HENDIZADEH",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-427-3678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "N005950-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.