Organization Active NPI

Clifton Park Podiatry, P.C.

  • Podiatrist
  • Clifton Park, NY
National Provider Identifier
1376654418
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004536 Issued in NY
Legal business name
CLIFTON PARK PODIATRY, P.C.
Practice address
1673 Route 9
Clifton Park, NY 12065-4397
Phone
(518) 383-3338
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Dr. Richard Berkowitz, DPMNPI 1346243441
Title
President
Phone
(518) 383-3338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N004536 NY Primary

Addresses

Primary practice location

1673 Route 9
Clifton Park, NY 12065-4397

Mailing address

1673 Route 9
Clifton Park, NY 12065-4397
Phone (518) 383-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080410000200 NY Part B Supplier - Clinic/Group Practice 1355428681 Receives reassigned benefits from 1 practitioner
Practice locations: Halfmoon, NY
O20100930047250 NY DME Supplier - Physician - Podiatry 1355428681 Practice locations: Clifton Park, NY

National Provider Directory

National Provider Directory

Locations

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Practitioners & affiliated clinicians

Practitioners 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1376654418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 ROUTE 9",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120654397",
            "telephone_number": "518-383-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 ROUTE 9",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120654397",
            "telephone_number": "518-383-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON PARK PODIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "BERKOWITZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-383-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.