Individual provider Active NPI

Mitchell Lee Steinberg, D.P.M.

  • Podiatrist
  • Setauket, NY
National Provider Identifier
1356336473
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
002518 Issued in NY
Practice address
11 Saint George Glen Dr
Setauket, NY 11733-1901
Phone
(631) 751-6665
Fax
(631) 751-6833
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 002518 NY Primary

Addresses

Primary practice location

11 Saint George Glen Dr
Setauket, NY 11733-1901

Mailing address

PO Box 573
Setauket, NY 11733-0573
Phone (631) 751-6665

Other identifiers 2

IdentifierTypeStateIssuer
004260311MedicaidNY
112590028OtherNYFEDERAL TAX ID

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
I20101004001157 NY Practitioner - Podiatry 4587856992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002518NYMDPodiatrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1356336473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 573",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117330573",
            "telephone_number": "631-751-6665",
            "fax_number": "631-751-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SAINT GEORGE GLEN DR",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331901",
            "telephone_number": "631-751-6665",
            "fax_number": "631-751-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEINBERG",
        "first_name": "MITCHELL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "002518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004260311",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "112590028",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Setauket, NY

Sources for this page

Verify at the official NPI Registry.