Individual provider Active NPI

Ian Keith Cook, DPM

  • Podiatrist
  • Roosevelt, NY
National Provider Identifier
1295836245
Registry record updated Feb 10, 2026
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(14) exclusion effective Dec 20, 2016.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005172 Issued in NY
Practice address
20 W Raymond Ave
Roosevelt, NY 11575-1014
Phone
(340) 713-8397
Fax
(340) 719-5103
NPI assigned
Sep 25, 2006
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 005172 NY Primary
Podiatrist 213E00000X 1058 VI

Addresses

Primary practice location

20 W Raymond Ave
Roosevelt, NY 11575-1014

Mailing address

20 W Raymond Ave
Roosevelt, NY 11575-1014
Phone (340) 713-8397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1058PRMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Foot Care PLLC Past Accepting new patients
Podiatric Medical Services for Ambulatory Services PLLC PastSince Oct 30, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1295836245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W RAYMOND AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751014",
            "telephone_number": "340-713-8397",
            "fax_number": "340-719-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W RAYMOND AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751014",
            "telephone_number": "340-713-8397",
            "fax_number": "340-719-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "IAN",
        "middle_name": "KEITH",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005172",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VI",
            "license": "1058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

Verify at the official NPI Registry.