Individual provider Active NPI

Edner Registre, D.P.M.

  • Podiatrist
  • Cambria Heights, NY
National Provider Identifier
1104231125
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
R93136 Issued in NY
Practice address
11572 Francis Lewis Blvd
Cambria Heights, NY 11411-1028
Phone
(718) 276-8666
NPI assigned
Jun 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 006837 NY
Podiatrist 213E00000X R93136 NY Primary

Addresses

Primary practice location

11572 Francis Lewis Blvd
Cambria Heights, NY 11411-1028

Mailing address

166 Roquette Ave
Elmont, NY 11003-1209
Phone (347) 679-5443

Other practice location 1

2525 Kings Hwy
Brooklyn, NY 11229-1705
Phone (718) 692-5300

Other practice location 2

10 E Merrick Rd Ste 301
Valley Stream, NY 11580-5800
Phone (347) 679-5443

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
I20170620002488 NY Practitioner - Podiatry 6204104003 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santi Podiatry Group PLLCGroup PAC ID 2860632957, 3 clinicians

Practice addresses (Care Compare)

240 E 5TH St
Brooklyn, NY 11218-2404
Phone (718) 435-1031

Hospital & facility affiliations

  • New York Community Hospital of Brooklyn, Inc. Hospital, Brooklyn, NY, CCN 330019

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue2212
Removal or shaving of skin growth2924

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006837NYMDPodiatrist
R93136NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Santi Podiatry Group PLLC CurrentSince Jul 1, 2017 Accepting new patients
South Shore Family Medical Associates, P.C. Past Accepting new patients
Charles J Pearlman MD PLLC Past Accepting new patients

Locations

240 E 5th St
Brooklyn, NY 11218
Phone (718) 435-1031

2525 Kings Hwy
Brooklyn, NY 11229
Phone (718) 692-5300

Networks

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1104231125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 ROQUETTE AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031209",
            "telephone_number": "347-679-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11572 FRANCIS LEWIS BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111028",
            "telephone_number": "718-276-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112291705",
            "country_code": "US",
            "telephone_number": "718-692-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 E Merrick Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115805800",
            "country_code": "US",
            "telephone_number": "347-679-5443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGISTRE",
        "first_name": "EDNER",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-28",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006837",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "R93136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambria Heights, NY

Sources for this page

Verify at the official NPI Registry.