Organization Active NPI

Jeffrey Schneller DPM PC

  • Podiatrist
  • Sunnyside, NY
National Provider Identifier
1366798381
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004139-1 Issued in NY
Legal business name
JEFFREY SCHNELLER DPM PC
Practice address
4555 43Rd St
Sunnyside, NY 11104-2609
Phone
(718) 729-1952
Fax
(718) 706-0170
NPI assigned
Jul 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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

Authorized official

Name
Dr. Jeffrey Alan Schneller, D.P.M., P.C.
Title
President
Phone
(718) 672-8266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N004139-1 NY Primary

Addresses

Primary practice location

4555 43Rd St
Sunnyside, NY 11104-2609

Mailing address

4555 43Rd St
Sunnyside, NY 11104-2609
Phone (718) 729-1952

Other identifiers 1

IdentifierTypeStateIssuer
00966610MedicaidNY

National Provider Directory

National Provider Directory

Locations

4555 43rd St
Sunnyside, NY 11104
Phone (718) 365-0256

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1366798381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 43RD ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042609",
            "telephone_number": "718-729-1952",
            "fax_number": "718-706-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4555 43RD ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042609",
            "telephone_number": "718-729-1952",
            "fax_number": "718-706-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY SCHNELLER DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "SCHNELLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-672-8266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M., P.C."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004139-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00966610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.