Individual provider Active NPI

Jeffrey C Tanenbaum, DPM

  • Podiatrist
  • Bronx, NY
National Provider Identifier
1346283298
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
006160 Issued in NY
Practice address
2015 Grand Concourse
Bronx, NY 10453-4303
Phone
(185) 837-7367
Fax
(718) 537-6180
NPI assigned
Jun 14, 2006
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 006160 NY Primary
Foot & Ankle Surgery Podiatrist 213ES0103X DP731 TX

Addresses

Primary practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Mailing address

2626 Halperin Ave
Bronx, NY 10461-2631
Phone (718) 618-0401

Other identifiers 1

IdentifierTypeStateIssuer
092830101MedicaidTX

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
I20240307001865 NY Practitioner - Podiatry 4981040367 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Care365 LLCGroup PAC ID 5496137325, 16 clinicians
Gregory Amante DPM, PCGroup PAC ID 9638353626, 3 clinicians
Gentle Touch Podiatric Care PCGroup PAC ID 3971000811, 3 clinicians
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians
Medcare, LLCGroup PAC ID 9537265541, 15 clinicians

Practice addresses (Care Compare)

1 Main St
Monsey, NY 10952-3704
Phone (212) 734-6621

242 Beach 20TH St
Far Rockaway, NY 11691-3618
Phone (718) 934-2211

2995 Ocean Pkwy
Brooklyn, NY 11235-8390
Phone (718) 975-3440

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

468 Lafayette Ave
Brooklyn, NY 11205-4809
Phone (718) 399-6234

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions63
Removal of nail tissue577
Removal or shaving of skin growth549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP731TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory Amante DPM, PC Foot & Ankle Surgery CurrentSince Dec 1, 2024 Accepting new patients
Essen Medical Associates, PC CurrentSince May 10, 2025 Accepting new patients
Care365 LLC CurrentSince Feb 9, 2025 Accepting new patients
Foot Forward Podiatry PC Podiatrist CurrentSince Feb 27, 2024 Accepting new patients
Medcare, LLC Podiatrist CurrentSince Jun 20, 2025 Accepting new patients
Gentle Touch Podiatric Care PC Podiatrist CurrentSince Aug 24, 2025 Accepting new patients
Essen Medical Associates, PC Podiatrist CurrentSince May 10, 2025 Accepting new patients
House Call Medical Services of New York, PLLC Podiatrist CurrentSince May 10, 2025 Accepting new patients
Richard Scott Kobylar J C Tanenbaum DPM PA & Associates Foot & Ankle Surgery Past Accepting new patients
Lafayette Medical Office, PC Podiatrist PastSince Jun 20, 2025 Accepting new patients

Locations

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2952 Brighton 3rd St
Ste 201
Brooklyn, NY 11235
Phone (718) 975-4334

468 Lafayette Ave
Brooklyn, NY 11205
Phone (718) 399-6234

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

242 Beach 20th St
Far Rockaway, NY 11691
Phone (718) 471-0982

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

918 James St
#13282
Syracuse, NY 13203

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

Organizations & group practices 11

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1346283298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 HALPERIN AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612631",
            "telephone_number": "718-618-0401",
            "fax_number": "347-479-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534303",
            "telephone_number": "185-837-7367",
            "fax_number": "718-537-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006160",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "DP731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092830101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.