Individual provider Active NPI

Stanley John Zawada, D.P.M.

  • Podiatrist
  • Whitestone, NY
National Provider Identifier
1326057514
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N-003845 Issued in NY
Practice address
1257 150TH St
Whitestone, NY 11357-1752
Phone
(718) 767-5555
Fax
(718) 767-5353
NPI assigned
Aug 5, 2006
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Podiatrist 213ER0200X N-003845 NY
Sports Medicine Podiatrist 213ES0000X N-003845 NY
Foot Surgery Podiatrist 213ES0131X N-003845 NY
Podiatrist 213E00000X N-003845 NY Primary

Addresses

Primary practice location

1257 150TH St
Whitestone, NY 11357-1752

Mailing address

1257 150TH St
Whitestone, NY 11357-1752
Phone (718) 767-5555

Other identifiers 1

IdentifierTypeStateIssuer
00858168MedicaidNY

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
I20210813001074 NY Practitioner - Podiatry 6204230113 Practice locations: Whitestone, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
N-003845NYMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
150 Street Corp. Podiatrist PastSince Sep 12, 2021 Accepting new patients

Organizations & group practices 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1326057514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 150TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571752",
            "telephone_number": "718-767-5555",
            "fax_number": "718-767-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 150TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571752",
            "telephone_number": "718-767-5555",
            "fax_number": "718-767-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAWADA",
        "first_name": "STANLEY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "NY",
            "license": "N-003845",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "N-003845",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N-003845",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N-003845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00858168",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

Verify at the official NPI Registry.