Individual provider Active NPI

Cecilia Capuano King, DPM

  • Podiatrist
  • Smithtown, NY
National Provider Identifier
1336232388
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005857 Issued in NY
Practice address
61 Route 111
Smithtown, NY 11787-3712
Phone
(631) 406-7778
Fax
(631) 724-0323
NPI assigned
Oct 2, 2006
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N005857 NY Primary

Addresses

Primary practice location

61 Route 111
Smithtown, NY 11787-3712

Mailing address

61 Route 111
Smithtown, NY 11787-3712
Phone (631) 406-7778

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
I20040325001673 NY Practitioner - Podiatry 5496669228 Reassigns benefits to 2 organizations
Practice locations: Commack, NY; Smithtown, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

52 Roosevelt Ave
Commack, NY 11725-1733
Phone (516) 857-3193

61 Route 111
Smithtown, NY 11787-3712
Phone (516) 857-3193

Merit-based Incentive Payment System (MIPS)

Final score
99.77 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions26
Removal of nail tissue1449
Removal or shaving of skin growth1008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005857NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert J. Gottlieb, DPM, PC Podiatrist CurrentSince Jun 30, 2011 Accepting new patients
Robert D. Berney PastSince Oct 25, 2020 Accepting new patients

Locations

283 Commack Rd
Ste 125
Commack, NY 11725
Phone (631) 335-3412

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1336232388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712",
            "telephone_number": "631-406-7778",
            "fax_number": "631-724-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712",
            "telephone_number": "631-406-7778",
            "fax_number": "631-724-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUANO KING",
        "first_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.