NPIMap

Organization Active NPI

Jay M Purvin, DPM

  • Podiatrist
  • East Meadow, NY
National Provider Identifier
1053483164
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
NO029711 Issued in NY
Legal business name
JAY M PURVIN, DPM
Practice address
336 Cedar LN
East Meadow, NY 11554-2714
Phone
(516) 489-1950
Fax
(516) 489-6861
NPI assigned
Nov 14, 2006
Last updated
Feb 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Jay M Purvin, DPMNPI 1053310920
Title
DPM
Phone
(516) 489-1950

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NO029711 NY Primary

Addresses

Primary practice location

336 Cedar LN
East Meadow, NY 11554-2714

Mailing address

336 Cedar LN
East Meadow, NY 11554-2714
Phone (516) 489-1950

Other identifiers 13

IdentifierTypeStateIssuer
00406217MedicaidNY
0758507MedicaidNJ
442480195OtherNYRAILROAD MEDICARE
6283312-006OtherNYCIGNA
0028525OtherNYGHI
1161608OtherNYHORIZON
4514751OtherNYAETNA
AS1651OtherNYOXFORD
040426008382OtherNYFIDELIS
1C1904OtherNYHEALTHNET
36608POtherNYHIP
303916OtherNYUNITED HEALTHCARE
N02971-A13OtherNYHEALTHFIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930033052 NY DME Supplier - Physician - PodiatryDME Supplier - Medical Supply Company 4880650316 Practice locations: East Meadow, NY

National Provider Directory

National Provider Directory
Tax ID family
Jay M Purvin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1053483164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 CEDAR LN",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542714",
            "telephone_number": "516-489-1950",
            "fax_number": "516-489-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CEDAR LN",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542714",
            "telephone_number": "516-489-1950",
            "fax_number": "516-489-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY M PURVIN, DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "PURVIN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "516-489-1950",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "NO029711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00406217",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0758507",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "442480195",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6283312-006",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0028525",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "1161608",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4514751",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "AS1651",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426008382",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1C1904",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "36608P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "303916",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHFIRST",
            "identifier": "N02971-A13",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.