Active NPI
Robert William Kanowitz, DPM
- Podiatrist
- Philadelphia, PA
National Provider Identifier
1205866464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SC002241L
- Practice address
- 12000 Bustleton Avenue
Philadelphia, PA 19116 - Phone
- (215) 969-4006
- Fax
- (610) 645-6556
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC002241L | PA | Primary |
Addresses
Primary practice location
12000 Bustleton Avenue
Philadelphia, PA 19116
Mailing address
418 Redleaf Road
Wynnewood, PA 19096
Phone (215) 969-4006
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0060731000 | Other | HMO ID | |
| 0697736 | Medicaid | PA | |
| 2431298000 | Other | PRACTICE HMO ID | |
| 2431298000 | Other | PA | DECS CHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041229000140 | PA | Practitioner - Podiatry | 7618935255 | Practice locations: Narberth, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205866464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "418 REDLEAF ROAD",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "19096",
"telephone_number": "215-969-4006",
"fax_number": "610-645-6556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 BUSTLETON AVENUE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19116",
"telephone_number": "215-969-4006",
"fax_number": "610-645-6556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANOWITZ",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "PA",
"license": "SC002241L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO ID",
"identifier": "0060731000",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0697736",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRACTICE HMO ID",
"identifier": "2431298000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DECS CHOICE",
"identifier": "2431298000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.