Individual provider Active NPI

Patricia Ann Nowell, DPM

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1104976505
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001108 Issued in GA
Practice address
741 E 22ND St
Brooklyn, NY 11210-1103
Phone
(718) 859-3983
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD001108 GA Primary
Podiatrist 213E00000X N004212 NY

Addresses

Primary practice location

741 E 22ND St
Brooklyn, NY 11210-1103

Mailing address

741 E 22ND St
Brooklyn, NY 11210-1103
Phone (718) 859-3983

Other identifiers 1

IdentifierTypeStateIssuer
542577732AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004212NYMDPodiatrist
POD001108GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Utilization Management Corporation Past Accepting new patients
St Lukes Roosevelt Community Care Podiatrist Past Accepting new patients
Sel Medical PC Past Accepting new patients
Astrocare Medical Services PC PastSince Sep 16, 2010 Accepting new patients
Beth Israel Medical Center Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1104976505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 E 22ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112101103",
            "telephone_number": "718-859-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 E 22ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112101103",
            "telephone_number": "718-859-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWELL",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001108",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "542577732A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.