Organization Active NPI

Westbury Podiatry PC

  • Podiatrist
  • Westbury, NY
National Provider Identifier
1225018641
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WESTBURY PODIATRY PC
Practice address
210 Fulton St
Westbury Podiatry PC
Westbury, NY 11590-3004
Phone
(516) 333-6800
Fax
(516) 333-6847
NPI assigned
Jan 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Allen Roth, DPM
Title
Copresident
Phone
(516) 333-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

210 Fulton St
Westbury Podiatry PC
Westbury, NY 11590-3004

Mailing address

210 Fulton St
Westbury Podiatry PC
Westbury, NY 11590-3004
Phone (516) 333-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091103000702 NY Part B Supplier - Clinic/Group Practice 4981742426 Receives reassigned benefits from 1 practitioner
Practice locations: Westbury, NY

National Provider Directory

National Provider Directory

Locations

210 Fulton St
Westbury, NY 11590
Phone (516) 333-6800

Practitioners & affiliated clinicians

Practitioners 1

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": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225018641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FULTON ST",
            "address_2": "WESTBURY PODIATRY PC",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903004",
            "telephone_number": "516-333-6800",
            "fax_number": "516-333-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FULTON ST",
            "address_2": "WESTBURY PODIATRY PC",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115903004",
            "telephone_number": "516-333-6800",
            "fax_number": "516-333-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTBURY PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "COPRESIDENT",
        "authorized_official_telephone_number": "516-333-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.