NPIMap

Organization Active NPI

Family Foot Care of Long Island, PLLC

  • Podiatrist
  • Port Jefferson Station, NY
National Provider Identifier
1235588765
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FAMILY FOOT CARE OF LONG ISLAND, PLLC
Practice address
1 Medical Dr Ste B
Port Jefferson Station, NY 11776-1599
Phone
(631) 928-8383
Fax
(631) 928-8388
NPI assigned
Jun 6, 2016
Last updated
Feb 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Authorized official

Name
Dr. Brent Thomas Kempf, D.P.M.NPI 1659483246
Title
Partner
Phone
(631) 567-2888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary
Primary Podiatric Medicine Podiatrist 213EP1101X NU
Radiology Podiatrist 213ER0200X NU
Sports Medicine Podiatrist 213ES0000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU
Foot Surgery Podiatrist 213ES0131X NU

Addresses

Primary practice location

1 Medical Dr Ste B
Port Jefferson Station, NY 11776-1599

Mailing address

1 Medical Dr Ste B
Port Jefferson Station, NY 11776-1599
Phone (631) 928-8383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170503002437 NY Part B Supplier - Clinic/Group Practice 5193002970 Receives reassigned benefits from 7 practitioners
Practice locations: Port Jefferson Station, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Foot Care of Long Island PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676073600000",
    "number": "1235588765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761599",
            "telephone_number": "631-928-8383",
            "fax_number": "631-928-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761599",
            "telephone_number": "631-928-8383",
            "fax_number": "631-928-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT CARE OF LONG ISLAND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A",
        "authorized_official_last_name": "KEMPF",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-567-2888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; 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.