Organization Active NPI

Foot and Ankle Orthopaedic Surgery, PC

  • Orthopaedic Foot and Ankle Surgery Physician
  • New York, NY
National Provider Identifier
1104902972
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
Legal business name
FOOT AND ANKLE ORTHOPAEDIC SURGERY, PC
Practice address
523 E 72ND St
Room 509
New York, NY 10021-4099
Phone
(212) 606-1579
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Martin J O'Malley, M.D.
Title
Manager
Phone
(212) 606-1579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0004X NY Primary

Addresses

Primary practice location

523 E 72ND St
Room 509
New York, NY 10021-4099

Mailing address

523 E 72ND St
Room 509
New York, NY 10021-4099
Phone (212) 606-1579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041230000730 NY Part B Supplier - Clinic/Group Practice 2264490614 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

420 E 72nd St
Ste 1B
New York, NY 10021
Phone (212) 203-0740

523 E 72nd St
Rm 509
New York, NY 10021
Phone (212) 606-1579

785 Mamaroneck Ave
#8
White Plains, NY 10605
Phone (914) 597-2332

Practitioners & affiliated clinicians

Practitioners 5

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104902972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 E 72ND ST",
            "address_2": "ROOM 509",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214099",
            "telephone_number": "212-606-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E 72ND ST",
            "address_2": "ROOM 509",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214099",
            "telephone_number": "212-606-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE ORTHOPAEDIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'MALLEY",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-606-1579",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.