Individual provider Active NPI

Daniel Basalely, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
National Provider Identifier
1275890063
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006679 Issued in NY
Practice address
1990A Lexington Ave
New York, NY 10035-2911
Phone
(516) 205-3099
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X N006679 NY Primary

Addresses

Primary practice location

1990A Lexington Ave
New York, NY 10035-2911

Mailing address

1990A Lexington Ave
New York, NY 10035-2911
Phone (516) 205-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151124000299 NY Practitioner - Podiatry 6608176607 Reassigns benefits to 2 organizations
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N006679NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jay Bienenfeld DPM PLLC CurrentSince Nov 21, 2023 Accepting new patients
Shadow Podiatry Foot & Ankle Surgery PastSince Jul 1, 2015 Accepting new patients

Locations

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1275890063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990A LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352911",
            "telephone_number": "516-205-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990A LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100352911",
            "telephone_number": "516-205-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASALELY",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.