Organization Active NPI

West Islip Foot Care PC

  • Sports Medicine Podiatrist
  • West Islip, NY
National Provider Identifier
1194802827
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine PodiatristTaxonomy code 213ES0000X
License
N003452 Issued in NY
Legal business name
WEST ISLIP FOOT CARE PC
Practice address
212 Higbie LN
Suite #2
West Islip, NY 11795-2827
Phone
(631) 661-7400
Fax
(631) 661-3958
NPI assigned
Nov 1, 2006
Last updated
Feb 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Ms. Bernadette Hayes
Title
MGR
Phone
(631) 661-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0000X N003452 NY Primary

Addresses

Primary practice location

212 Higbie LN
Suite #2
West Islip, NY 11795-2827

Mailing address

212 Higbie LN
Suite #2
West Islip, NY 11795-2827
Phone (631) 661-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071106000580 NY Part B Supplier - Clinic/Group Practice 4880781947 Receives reassigned benefits from 1 practitioner
Practice locations: West Islip, NY
O20100930019279 NY DME Supplier - Physician - Podiatry 4880781947 Practice locations: West Islip, NY

National Provider Directory

National Provider Directory

Locations

212 Higbie Ln
West Islip, NY 11795
Phone (516) 696-0123

212 Higbie Ln
Ste 2
West Islip, NY 11795
Phone (631) 661-7400

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1194802827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGBIE LN",
            "address_2": "SUITE #2",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952827",
            "telephone_number": "631-661-7400",
            "fax_number": "631-661-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGBIE LN",
            "address_2": "SUITE #2",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952827",
            "telephone_number": "631-661-7400",
            "fax_number": "631-661-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST ISLIP FOOT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "631-661-7400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "N003452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.