Individual provider Active NPI

Kristin Elisa Janson, D.P.M.

  • Podiatrist
  • New York, NY
National Provider Identifier
1104802081
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004687 Issued in NY
Practice address
185 Madison Ave RM 802
New York, NY 10016-0020
Phone
(212) 689-9388
Fax
(212) 689-0195
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004687 NY Primary

Addresses

Primary practice location

185 Madison Ave RM 802
New York, NY 10016-0020

Mailing address

185 Madison Ave RM 802
New York, NY 10016-0020
Phone (212) 689-9388

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
I20100629000000 NY Practitioner - Podiatry 5698806040 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

185 Madison Ave
RM 802
New York, NY 10016-0020
Phone (212) 689-9388

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004687NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1104802081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MADISON AVE RM 802",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160020",
            "telephone_number": "212-689-9388",
            "fax_number": "212-689-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MADISON AVE RM 802",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160020",
            "telephone_number": "212-689-9388",
            "fax_number": "212-689-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSON",
        "first_name": "KRISTIN",
        "middle_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.