NPIMap

Organization Active NPI

North Country Podiatry

  • Podiatrist
  • Mount Sinai, NY
National Provider Identifier
1164674347
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003743 Issued in NY
Legal business name
NORTH COUNTRY PODIATRY
Practice address
626 Canal Rd
Mount Sinai, NY 11766-3309
Phone
(631) 331-3338
Fax
(631) 331-0014
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Authorized official

Name
Dr. Mark Geoffrey Gresser, DPMNPI 1326056508
Title
President
Phone
(631) 331-3338

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N003743 NY Primary

Addresses

Primary practice location

626 Canal Rd
Mount Sinai, NY 11766-3309

Mailing address

626 Canal Rd
Mount Sinai, NY 11766-3309
Phone (631) 331-3338

Other identifiers 1

IdentifierTypeStateIssuer
00886888MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1164674347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 CANAL RD",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117663309",
            "telephone_number": "631-331-3338",
            "fax_number": "631-331-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 CANAL RD",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117663309",
            "telephone_number": "631-331-3338",
            "fax_number": "631-331-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "GRESSER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "GEOFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-331-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00886888",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Sinai, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.