Organization Active NPI

Balance Foot and Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • West Babylon, NY
National Provider Identifier
1063074565
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
BALANCE FOOT AND ANKLE LLC
Practice address
229 Great East Neck Rd
West Babylon, NY 11704-7801
Phone
(516) 344-5553
NPI assigned
Jul 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Tyler Miranda, DPMNPI 1760894125
Title
Owner
Phone
(845) 596-4745

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

229 Great East Neck Rd
West Babylon, NY 11704-7801

Mailing address

5 Marlborough CT
Rockville Centre, NY 11570-1822
Phone (845) 596-4745

Other practice location 1

26402 Hillside Ave
Floral Park, NY 11004-1738
Phone (845) 596-4745

Other practice location 2

119 N Park Ave
Rockville Centre, NY 11570-4113
Phone (845) 596-4745

Other practice location 3

61 N Park Ave
Rockville Centre, NY 11570-4105
Phone (845) 596-4745

Other identifiers 1

IdentifierTypeStateIssuer
04294551MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NUEMD

National Provider Directory

National Provider Directory

Locations

229 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 661-0073

Practitioners & affiliated clinicians

Practitioners 2

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": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1063074565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MARLBOROUGH CT",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701822",
            "telephone_number": "845-596-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 GREAT EAST NECK RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117047801",
            "telephone_number": "516-344-5553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26402 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Floral Park",
            "state": "NY",
            "postal_code": "110041738",
            "country_code": "US",
            "telephone_number": "845-596-4745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 N Park Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115704113",
            "country_code": "US",
            "telephone_number": "845-596-4745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 N Park Ave",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115704105",
            "country_code": "US",
            "telephone_number": "845-596-4745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BALANCE FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-596-4745",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04294551",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NUEMD",
            "affiliation": "N",
            "address_1": "611 Mitchel Field Way",
            "city": "Garden City",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115305057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.