Individual provider Active NPI

Marc Jay Pinsky, D.P.M.

  • Podiatrist
  • Petersburg, VA
National Provider Identifier
1174590186
Registry record updated Sep 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103000414 Issued in VA
Practice address
3333 S Crater Rd
Suite 3E
Petersburg, VA 23805-9276
Phone
(804) 732-6000
Fax
(804) 861-6885
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0103000414 VA Primary

Addresses

Primary practice location

3333 S Crater Rd
Suite 3E
Petersburg, VA 23805-9276

Mailing address

PO Box 1853
Petersburg, VA 23805-0853
Phone (804) 732-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0103000414VAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Cardiology CurrentSince Oct 1, 2017 Accepting new patients
Commonwealth of Virginia Hiram W. Davis Medical Center Past Accepting new patients

Locations

3333 S Crater Rd
Ste 3E
Petersburg, VA 23805
Phone (804) 203-0620

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347667200000",
    "number": "1174590186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1853",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238050853",
            "telephone_number": "804-732-6000",
            "fax_number": "804-861-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S CRATER RD",
            "address_2": "SUITE 3E",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059276",
            "telephone_number": "804-732-6000",
            "fax_number": "804-861-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINSKY",
        "first_name": "MARC",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2012; 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.