Organization Active NPI

Oceanside Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Oceanside, NY
National Provider Identifier
1104913706
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
OCEANSIDE PODIATRY
Practice address
2965 Long Beach Rd
Oceanside, NY 11572-3204
Phone
(516) 766-8500
Fax
(516) 766-8526
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Mrs. Josette Zappa
Title
Office Manager
Phone
(516) 766-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X NY Primary

Addresses

Primary practice location

2965 Long Beach Rd
Oceanside, NY 11572-3204

Mailing address

2965 Long Beach Rd
Oceanside, NY 11572-3204
Phone (516) 766-8500

Other identifiers 2

IdentifierTypeStateIssuer
01674799MedicaidNY
01172747MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325001067 NY Part B Supplier - Clinic/Group Practice 1456243443 Receives reassigned benefits from 2 practitioners
Practice locations: Oceanside, NY
O20100930097169 NY DME Supplier - Physician - Podiatry 1456243443 1 other NPI on this enrollment
Practice locations: Oceanside, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1040 Hempstead Tpke
Ste 11
Franklin Square, NY 11010
Phone (516) 352-1136

3105 Lawson Blvd
Oceanside, NY 11572
Phone (516) 766-8500

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1104913706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723204",
            "telephone_number": "516-766-8500",
            "fax_number": "516-766-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723204",
            "telephone_number": "516-766-8500",
            "fax_number": "516-766-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANSIDE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "ZAPPA",
        "authorized_official_first_name": "JOSETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-766-8500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01674799",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01172747",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.