NPIMap

Organization Active NPI

Kingsmount Inc.

  • Durable Medical Equipment & Medical Supplies
  • Philadelphia, PA
National Provider Identifier
1376576355
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
6000005644 Issued in PA
Legal business name
KINGSMOUNT INC.
Doing business as
Foot Comfort Center - Italian Shoe Warehouse
Practice address
9808 Bustleton Ave
Philadelphia, PA 19115-2190
Phone
(215) 676-7463
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Authorized official

Name
Sofya Tamarkin
Title
Manager
Phone
(215) 676-7463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 6000005644 PA Primary

Addresses

Primary practice location

9808 Bustleton Ave
Philadelphia, PA 19115-2190

Mailing address

9808 Bustleton Ave
Philadelphia, PA 19115-2190
Phone (215) 676-7463

Other identifiers 6

IdentifierTypeStateIssuer
1148890OtherPAPROV ID- KEYSTONE MERCY
240588OtherPAPROV ID - BLUE CROSS
HEALTH PARTNERSOtherPA31636
0005147000OtherPAPROV ID - KEYSTONE HPE
0018439280002MedicaidPA
AMERICHOICEOtherPA01843928-01

Other names 1

  • Foot Comfort Center - Italian Shoe Warehouse Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930015790 PA DME Supplier - Medical Supply CompanyDME Supplier - Pedorthic Personnel 2961513346 Practice locations: Philadelphia, PA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Foot Comfort Center9808 Bustleton Ave, Philadelphia, PA 19115-2190(215) 676-7463 Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Jan 31, 2001

National Provider Directory

National Provider Directory
Tax ID family
Kingsmount Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186012800000",
    "number": "1376576355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152190",
            "telephone_number": "215-676-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9808 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152190",
            "telephone_number": "215-676-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSMOUNT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-08-02",
        "status": "A",
        "authorized_official_last_name": "TAMARKIN",
        "authorized_official_first_name": "SOFYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-676-7463"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "6000005644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROV ID- KEYSTONE MERCY",
            "identifier": "1148890",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROV ID - BLUE CROSS",
            "identifier": "240588",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "31636",
            "identifier": "HEALTH PARTNERS",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROV ID - KEYSTONE HPE",
            "identifier": "0005147000",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018439280002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01843928-01",
            "identifier": "AMERICHOICE",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot Comfort Center - Italian Shoe Warehouse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.