Individual provider Active NPI

Craig Brandoff, DPM

  • Foot Surgery Podiatrist
  • New York, NY
National Provider Identifier
1184767055
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N004210 Issued in NY
Practice address
42 Broadway
Suite 1638
New York, NY 10004-1617
Phone
(212) 742-0652
Fax
(212) 755-7429
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 N004210 NY Primary

Addresses

Primary practice location

42 Broadway
Suite 1638
New York, NY 10004-1617

Mailing address

42 Broadway
Suite 1638
New York, NY 10004-1617
Phone (212) 742-0652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2016 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004210NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Anesthesia PC Past Accepting new patients
American Anesthesia, PC Past Accepting new patients

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184767055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BROADWAY",
            "address_2": "SUITE 1638",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041617",
            "telephone_number": "212-742-0652",
            "fax_number": "212-755-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 BROADWAY",
            "address_2": "SUITE 1638",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041617",
            "telephone_number": "212-742-0652",
            "fax_number": "212-755-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDOFF",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N004210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.