NPIMap

Organization Active NPI

Jefferson Valley Podiatry Associates, P.C.

  • Podiatrist
  • Jefferson Valley, NY
National Provider Identifier
1093012114
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003506 Issued in NY
Legal business name
JEFFERSON VALLEY PODIATRY ASSOCIATES, P.C.
Practice address
3630 Hill Blvd
Suite 104
Jefferson Valley, NY 10535-1502
Phone
(914) 962-5571
Fax
(914) 962-5574
NPI assigned
Feb 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Authorized official

Name
Dr. Arnold L. Isaacson, DPMNPI 1205990017
Title
President
Phone
(914) 962-5571

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X N003506 NY Primary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X N002571 NY

Addresses

Primary practice location

3630 Hill Blvd
Suite 104
Jefferson Valley, NY 10535-1502

Mailing address

3630 Hill Blvd
Suite 104
Jefferson Valley, NY 10535-1502
Phone (914) 962-5571

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110509000142 NY Part B Supplier - Clinic/Group Practice 0547445538 Receives reassigned benefits from 1 practitioner
Practice locations: Jefferson Valley, NY

National Provider Directory

National Provider Directory

Locations

3630 Hill Blvd
Ste 104
Jefferson Vly, NY 10535
Phone (914) 240-3700

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": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1093012114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 HILL BLVD",
            "address_2": "SUITE 104",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351502",
            "telephone_number": "914-962-5571",
            "fax_number": "914-962-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HILL BLVD",
            "address_2": "SUITE 104",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351502",
            "telephone_number": "914-962-5571",
            "fax_number": "914-962-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON VALLEY PODIATRY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "ISAACSON",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-962-5571",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003506",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N002571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.