NPIMap

Organization Active NPI

Centerock Podiatry Associates, PC

  • Foot & Ankle Surgery Podiatrist
  • West Nyack, NY
National Provider Identifier
1124053640
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CENTEROCK PODIATRY ASSOCIATES, PC
Practice address
2 Crosfield Ave
Suite 302
West Nyack, NY 10994-2226
Phone
(845) 358-2844
Fax
(845) 358-0528
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Authorized official

Name
Charles J Wolff, DPMNPI 1407875966
Title
President
Phone
(845) 358-2844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

2 Crosfield Ave
Suite 302
West Nyack, NY 10994-2226

Mailing address

2 Crosfield Ave
Suite 302
West Nyack, NY 10994-2226
Phone (845) 358-2844

Other identifiers 1

IdentifierTypeStateIssuer
1057830001OtherNYDME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20051209000102 NJ Part B Supplier - Clinic/Group Practice 1557253457 Receives reassigned benefits from 5 practitioners
Practice locations: Ramsey, NJ
O20060112000439 NY Part B Supplier - Clinic/Group Practice 1557253457 Receives reassigned benefits from 6 practitioners
Practice locations: West Nyack, NY
O20100930020658 NY DME Supplier - Physician - Podiatry 1557253457 Practice locations: West Nyack, NY

National Provider Directory

National Provider Directory

Locations

70 Hatfield Ln
Ste 202
Goshen, NY 10924
Phone (845) 291-3656

2 Crosfield Ave
Ste 302
West Nyack, NY 10994
Phone (845) 353-4344

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1124053640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "address_2": "SUITE 302",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-2844",
            "fax_number": "845-358-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "address_2": "SUITE 302",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-2844",
            "fax_number": "845-358-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTEROCK PODIATRY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-358-2844",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1057830001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.