Organization Active NPI

Ideal Foot Care PC

  • Foot & Ankle Surgery Podiatrist
  • Astoria, NY
National Provider Identifier
1255754917
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
006526 Issued in NY
Legal business name
IDEAL FOOT CARE PC
Practice address
3116 30TH Ave
Suite 203
Astoria, NY 11102-1571
Phone
(718) 545-3338
Fax
(718) 626-3034
NPI assigned
Jan 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Dr. Albert Samandarov, D.P.MNPI 1528364353
Title
Podiatrist
Phone
(718) 545-3338

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 006526 NY Primary

Addresses

Primary practice location

3116 30TH Ave
Suite 203
Astoria, NY 11102-1571

Mailing address

3116 30TH Ave
Suite 203
Astoria, NY 11102-1571
Phone (718) 545-3338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150105000830 NY Part B Supplier - Clinic/Group Practice 0244454304 Receives reassigned benefits from 3 practitioners
Practice locations: Floral Park, NY; Brooklyn, NY; Astoria, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1255754917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 30TH AVE",
            "address_2": "SUITE 203",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021571",
            "telephone_number": "718-545-3338",
            "fax_number": "718-626-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3116 30TH AVE",
            "address_2": "SUITE 203",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021571",
            "telephone_number": "718-545-3338",
            "fax_number": "718-626-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL FOOT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "SAMANDAROV",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "718-545-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.