NPIMap

Organization Active NPI

Country Foot Care Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Patchogue, NY
National Provider Identifier
1184099442
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
COUNTRY FOOT CARE PODIATRY PLLC
Practice address
4 Phyllis Dr
Patchogue, NY 11772-2900
Phone
(631) 475-3030
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Steven Brook, DPM
Title
Owner
Phone
(516) 741-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

4 Phyllis Dr
Patchogue, NY 11772-2900

Mailing address

173 Mineola Blvd
Suite 201
Mineola, NY 11501-2528
Phone (516) 741-3338

National Provider Directory

National Provider Directory

Locations

4 Phyllis Dr
Patchogue, NY 11772
Phone (631) 289-4700

479 Willis Ave
Williston Pk, NY 11596
Phone (516) 294-8877

Practitioners & affiliated clinicians

Practitioners 9

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": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1184099442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MINEOLA BLVD",
            "address_2": "SUITE 201",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012528",
            "telephone_number": "516-741-3338",
            "fax_number": "516-506-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PHYLLIS DR",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722900",
            "telephone_number": "631-475-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY FOOT CARE PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "BROOK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-741-3338",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.