Individual provider Active NPI

Ravi Kaizer Kamble, D.P.M.

  • Foot Surgery Podiatrist
  • Staten Island, NY
National Provider Identifier
1174505630
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N005931 Issued in NY
Practice address
2338 Richmond Rd
Staten Island, NY 10306-2346
Phone
(718) 979-1333
Fax
(718) 351-3215
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X N005931 NY Primary

Addresses

Primary practice location

2338 Richmond Rd
Staten Island, NY 10306-2346

Mailing address

2338 Richmond Rd
Staten Island, NY 10306-2346
Phone (718) 979-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000423 NY Practitioner - Podiatry 9234154857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2338 Richmond Rd
Staten Island, NY 10306-2346
Phone (718) 979-1333

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue75
Removal or shaving of skin growth53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005931NYMDMental Health Counselor
N005931NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Associates of New York PC Foot Surgery CurrentSince Feb 7, 2011 Accepting new patients
MMC University Vascular Surgeons Past Accepting new patients

Locations

11 Ralph Pl
Ste 304
Staten Island, NY 10304
Phone (718) 980-0188

2338 Richmond Rd
Staten Island, NY 10306
Phone (718) 979-1333

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1174505630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062346",
            "telephone_number": "718-979-1333",
            "fax_number": "718-351-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062346",
            "telephone_number": "718-979-1333",
            "fax_number": "718-351-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBLE",
        "first_name": "RAVI",
        "middle_name": "KAIZER",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N005931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.