Individual provider Active NPI

Stephen B. Chernick, DPM

  • Podiatrist
  • Forest Hills, NY
National Provider Identifier
1063507960
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
003399 Issued in NY
Practice address
11247 Queens Blvd
Suite 104/105
Forest Hills, NY 11375-7417
Phone
(718) 793-3223
Fax
(718) 793-0838
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 003399 NY Primary

Addresses

Primary practice location

11247 Queens Blvd
Suite 104/105
Forest Hills, NY 11375-7417

Mailing address

175 Fulton Ave
Ste 210
Hempstead, NY 11550-3702
Phone (718) 793-3223

Other identifiers 1

IdentifierTypeStateIssuer
00763786MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090210000339 NY Practitioner - Podiatry 4789749615 Reassigns benefits to 3 organizations
Practice locations: Forest Hills, NY; Hempstead, NY; Floral Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Footcare Now Podiatry, PLLCGroup PAC ID 1759613912, 7 clinicians
Country Foot Care Podiatry PLLCGroup PAC ID 1254634223, 6 clinicians

Practice addresses (Care Compare)

11241 Queens Blvd
Forest Hills, NY 11375-5564
Phone (718) 793-3223

3757 91St St
Jackson Heights, NY 11372-7968

479 Willis Ave
Williston Park, NY 11596-1725
Phone (516) 741-3338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions183
Removal of nail tissue1716
Removal or shaving of skin growth1049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Nov 1, 2017 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Nov 1, 2017 Accepting new patients
Country Foot Care Podiatry PLLC CurrentSince Sep 3, 2023 Accepting new patients
Footcare Now Podiatry, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Country Foot Care Podiatry PLLC CurrentSince Sep 3, 2023 Accepting new patients

Locations

11241 Queens Blvd
Ste Llb
Forest Hills, NY 11375
Phone (718) 261-1759

1436 Broadway
Hewlett, NY 11557
Phone (516) 563-7200

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

3757 91st St
Jackson Hts, NY 11372
Phone (718) 651-6500

155 Mineola Blvd
Ste B
Mineola, NY 11501
Phone (516) 741-3338

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

479 Willis Ave
Williston Pk, NY 11596
Phone (516) 294-8877

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1063507960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FULTON AVE",
            "address_2": "STE 210",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115503702",
            "telephone_number": "718-793-3223",
            "fax_number": "718-793-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11247 QUEENS BLVD",
            "address_2": "SUITE 104/105",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757417",
            "telephone_number": "718-793-3223",
            "fax_number": "718-793-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNICK",
        "first_name": "STEPHEN",
        "middle_name": "B.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "003399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00763786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.