Active NPI
Stanley John Zawada, D.P.M.
- Podiatrist
- Whitestone, NY
National Provider Identifier
1326057514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N-003845
- 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, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00858168 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N-003845 | NY | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 150 Street Corp. | Podiatrist | Past | 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.
-
- Podiatrist
- Whitestone, NY
- NPI 1093846081
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.