NPIMap

Organization Active NPI

New York University

Doing business as NYU Langone Podiatry Associates Upper West Side

  • Podiatrist
  • Boynton Beach, FL
National Provider Identifier
1053836908
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NEW YORK UNIVERSITY
Doing business as
NYU Langone Podiatry Associates Upper West Side
Practice address
3301 Quantum Blvd
Boynton Beach, FL 33426-8668
Phone
(877) 648-2964
NPI assigned
Aug 11, 2017
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Andrew T Rubin
Title
VP, Clinical Affairs and Amb. Care
Phone
(212) 263-2672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

3301 Quantum Blvd
Boynton Beach, FL 33426-8668

Mailing address

101 W 79TH St
New York, NY 10024-6474
Phone (212) 874-3578

Other practice location 1

101 W 79th St
New York, NY 10024-6474
Phone (212) 874-3578

Other names 1

  • NYU Langone Podiatry Associates Upper West Side Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171104000272 NY DME Supplier - Physician - General Practice 1355232422 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Tax ID family
New York University School of Medicine105 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NYU Langone HospitalsNew York, NY, CCN 330214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone Hospitals Psychiatric UnitNew York, NY, CCN 33S214 Hospital Operational/Managerial Control Apr 1, 2015
NYU Langone HospitalsMineola, NY, CCN 33021401 Hospital Operational/Managerial Control Aug 1, 2019
NYU Langone Amb Care CommackGarden City, NY, CCN 337187 Home health agency Operational/Managerial Control Apr 1, 2015

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1053836908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246474",
            "telephone_number": "212-874-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 QUANTUM BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268668",
            "telephone_number": "877-648-2964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W 79th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100246474",
            "country_code": "US",
            "telephone_number": "212-874-3578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW YORK UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-11",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, CLINICAL AFFAIRS AND AMB. CARE",
        "authorized_official_telephone_number": "212-263-2672"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYU Langone Podiatry Associates Upper West Side",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.