Suffolk County Foot Care PLLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

SUFFOLK COUNTY FOOT CARE PLLC

Practice address

63 Main St
Kings Park, NY 11754-2706

Phone

(631) 269-4600

Fax

(631) 269-0801

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stephen B Ravitz, DPMNPI 1407933484

Title

Podiatrist

Phone

(631) 269-4600

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Bradley Ravitz, DPM

  • Podiatrist
  • Kings Park, NY
  • NPI 1407933484
  Medicare reassignment Authorized official
• Anthony Vincent Zizzamia, DPM

  • Foot & Ankle Surgery Podiatrist
  • Smithtown, NY
  • NPI 1801237425
  Medicare reassignment

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1114023660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542706",
            "telephone_number": "631-269-4600",
            "fax_number": "631-269-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542706",
            "telephone_number": "631-269-4600",
            "fax_number": "631-269-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK COUNTY FOOT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "RAVITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "631-269-4600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAID",
            "identifier": "02216448",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "P55031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAID",
            "identifier": "01271269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2154835",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "130904",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "CS267",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9653126",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2654015",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01271269",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "19966",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6299184",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Stanley
• Eric Steinberg, R.PH. M.S. C.G.P.
• Lauren Stfleur
• Stonybrook University Medical Center
• Jennie Sucilsky, LCSW
• Suffolk County Foot Care PLLC
• Jane R Tanzi Afati
• Joseph John Tarantola, PHARMACIST
• Lawrence Eugene Taub, MSW
• Kenneth Louis Teape

• Podiatric Clinic/Center in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Podiatric Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.