Active NPI
Ian Keith Cook, DPM
- Podiatrist
- Roosevelt, NY
National Provider Identifier
1295836245
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.
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 005172
- 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, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1058 | PR | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Foot Care PLLC | Past | Accepting new patients | |
| Podiatric Medical Services for Ambulatory Services PLLC | Past | 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.
-
- Foot & Ankle Surgery Podiatrist
- Roosevelt, NY
- NPI 1043332026
-
- Foot & Ankle Surgery Podiatrist
- St Croix, VI
- NPI 1427170729
-
- Ambulatory Surgical Clinic/Center
- St Croix, VI
- NPI 1164545950
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.