5TH Avenue Podiatry, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N004656 Issued in NY

Legal business name

5TH AVENUE PODIATRY, PC

Practice address

36 W 44TH St
Suite 401
New York, NY 10036-8102

Phone

(212) 768-7999

Fax

(212) 398-8356

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ben Dimichino, D.P.M.

Title

President

Phone

(212) 768-7999

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1164586723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W 44TH ST",
            "address_2": "SUITE 401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368102",
            "telephone_number": "212-768-7999",
            "fax_number": "212-398-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W 44TH ST",
            "address_2": "SUITE 401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368102",
            "telephone_number": "212-768-7999",
            "fax_number": "212-398-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH AVENUE PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "DIMICHINO",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-768-7999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0020595",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4450726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "792279003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SH",
            "identifier": "P94591",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2C2743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1537389",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in New York, NY
• Providers in New York, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.