Individual provider Active NPI

Brian Dawson, DPM

  • Sports Medicine Podiatrist
  • Smithtown, NY
National Provider Identifier
1063763522
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
License
65 006511 Issued in NY
Practice address
74 Amsterdam Rd
Smithtown, NY 11787-3122
Phone
(646) 918-4393
NPI assigned
Sep 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine Podiatrist 213ES0000X 65 006511 NY Primary

Addresses

Primary practice location

74 Amsterdam Rd
Smithtown, NY 11787-3122

Mailing address

74 Amsterdam Rd
Smithtown, NY 11787-3122
Phone (646) 918-4393

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
I20150709002136 NY Practitioner - Podiatry 3971815598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65 006511NYMDSports Medicine Podiatrist
006511NYMDFeeding, Eating & Swallowing Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Podiatry PLLC Current Accepting new patients
Michael H. Loshigian, DPM, PC CurrentSince Jul 1, 2015 Accepting new patients

Locations

16216 Union Tpke
Ste 306
Fresh Meadows, NY 11366
Phone (718) 380-7900

225 W 34th St
Ste 1005
New York, NY 10122
Phone (212) 564-7644

Organizations & group practices 2

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": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1063763522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 AMSTERDAM RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873122",
            "telephone_number": "646-918-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 AMSTERDAM RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873122",
            "telephone_number": "646-918-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "65 006511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.