Organization Active NPI

Cross County Podiatry, PC

  • Foot & Ankle Surgery Podiatrist
  • Floral Park, NY
National Provider Identifier
1275128126
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CROSS COUNTY PODIATRY, PC
Practice address
25062 Jericho Tpke
Floral Park, NY 11001-4004
Phone
(646) 535-3668
NPI assigned
Mar 3, 2021
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, DPMNPI 1528364353
Title
Podiatrist
Phone
(917) 440-9562

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 Primary

Addresses

Primary practice location

25062 Jericho Tpke
Floral Park, NY 11001-4004

Mailing address

3116 30TH Ave Ste 203
Astoria, NY 11102-1545
Phone (718) 626-3338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121002551 NY DME Supplier - Physician - Podiatry 0143759183 Practice locations: Floral Park, NY

National Provider Directory

National Provider Directory

Locations

25062 Jericho Tpke
Floral Park, NY 11001
Phone (646) 535-3668

Practitioners & affiliated clinicians

Practitioners 3

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": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1275128126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 30TH AVE STE 203",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021545",
            "telephone_number": "718-626-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25062 JERICHO TPKE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110014004",
            "telephone_number": "646-535-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS COUNTY PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "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": "917-440-9562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, 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.