Organization Active NPI

Dyker Park Footcare, PLLC.

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1285887422
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006056 Issued in NY
Legal business name
DYKER PARK FOOTCARE, PLLC.
Practice address
8404 13TH Ave
Brooklyn, NY 11228-3302
Phone
(718) 745-6220
Fax
(718) 745-6229
NPI assigned
Oct 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Dr. Pasquale Michael Desanto, DPMNPI 1477527935
Title
Podiatrist
Phone
(718) 745-6220

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 N006056 NY Primary

Addresses

Primary practice location

8404 13TH Ave
Brooklyn, NY 11228-3302

Mailing address

8404 13TH Ave
Brooklyn, NY 11228-3302
Phone (718) 745-6220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081218000296 NY Part B Supplier - Clinic/Group Practice 9133281504 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

8404 13th Ave
Brooklyn, NY 11228
Phone (718) 745-6220

Practitioners & affiliated clinicians

Practitioners 4

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": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1285887422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8404 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283302",
            "telephone_number": "718-745-6220",
            "fax_number": "718-745-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8404 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283302",
            "telephone_number": "718-745-6220",
            "fax_number": "718-745-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYKER PARK FOOTCARE, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "DESANTO",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "718-745-6220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; 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.