Park Row Podiatry Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E2474 Issued in CA

Legal business name

PARK ROW PODIATRY INC.

Doing business as

Nicholas N. DeSantis DPM

Practice address

2306 6TH Ave
San Diego, CA 92101-1643

Phone

(619) 239-3286

Fax

(619) 239-0172

NPI assigned

Jul 28, 2010

Last updated

Nov 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Nelson Desantis, DPMNPI 1053317545

Title

Ceo/Owner

Phone

(619) 239-3286

Specialties & licenses 1

Addresses

Other names 1

• Nicholas N. DeSantis DPM Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Nelson Desantis, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • San Diego, CA
  • NPI 1053317545
  Medicare reassignment NPD Authorized official
• Mitchell L Feingold, D.P.M.

  • Podiatrist
  • San Diego, CA
  • NPI 1568404572
  NPD (past)
• Jerome Anthony Wisniew, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Diego, CA
  • NPI 1033128053
  NPD (past)

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1164736476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 6TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011643",
            "telephone_number": "619-239-3286",
            "fax_number": "619-239-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 6TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011643",
            "telephone_number": "619-239-3286",
            "fax_number": "619-239-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK ROW PODIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "DESANTIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "619-239-3286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicholas N. DeSantis DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Park Medical Physical Therapy, Prof Corp
• Park Medical Supplies, Inc
• Park Optometry, Inc
• Aaron Park
• Aaron Park
• Alice Park
• Andrew C Park, DMD
• Angela Solji Park, DO

• Foot & Ankle Surgery Podiatrist in San Diego, CA
• Providers in San Diego, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.