Individual provider Active NPI

Ayman Maurice Latif, DPM

  • Podiatrist
  • Middletown, CT
National Provider Identifier
1043488422
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000839 Issued in CT
Practice address
535 Saybrook Rd
Middletown, CT 06457-4743
Phone
(860) 346-5226
Fax
(860) 347-6280
NPI assigned
Feb 19, 2008
Last updated
Jan 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00294100 NJ
Podiatrist 213E00000X 000839 CT Primary

Addresses

Primary practice location

535 Saybrook Rd
Middletown, CT 06457-4743

Mailing address

535 Saybrook Rd
Middletown, CT 06457-4743
Phone (860) 346-5226

Other identifiers 2

IdentifierTypeStateIssuer
4997100002OtherCTNSC PROVIDER#
4997100006OtherCTNSC PROVIDER#

Other names 1

  • Dr. Ayman Maurice Latif Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20081114000219 CT Practitioner - Podiatry 5395805873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Foot Care Centers LLCGroup PAC ID 7517054067, 4 clinicians

Practice addresses (Care Compare)

505 Willard Ave
Suite D Building 2
Newington, CT 06111-2650
Phone (860) 666-2078

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue51
Removal of skin lesions1-10
Removal of nail tissue597
Removal or shaving of skin growth571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
839CTMDClinical Social Worker
25MD00294100NJMDFoot & Ankle Surgery Podiatrist
000839CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Foot Care Centers LLC Podiatrist CurrentSince Aug 4, 2008 Accepting new patients
Connecticut Foot Care Centers LLC Podiatrist CurrentSince Aug 4, 2008 Accepting new patients
Connecticut Foot Care Centers LLC Podiatrist Past Accepting new patients

Locations

300 Hebron Ave
Ste 105
Glastonbury, CT 06033
Phone (860) 633-6749

535 Saybrook Rd
Middletown, CT 06457
Phone (860) 344-8606

85 Church St
Ste 500
Middletown, CT 06457
Phone (860) 346-8657

505 Willard Ave
#2
Newington, CT 06111
Phone (860) 666-2078

505 Willard Ave
Ste D
Newington, CT 06111
Phone (860) 665-2078

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1043488422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574743",
            "telephone_number": "860-346-5226",
            "fax_number": "860-347-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574743",
            "telephone_number": "860-346-5226",
            "fax_number": "860-347-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIF",
        "first_name": "AYMAN",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00294100",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER#",
            "identifier": "4997100002",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER#",
            "identifier": "4997100006",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYMAN",
            "last_name": "LATIF",
            "middle_name": "MAURICE",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.