Active NPI
Thomas R Penny, DPM
- Primary Podiatric Medicine Podiatrist
- Bronx, NY
National Provider Identifier
1376695361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- N003426
- Practice address
- 2045 Lafayette Ave
Bronx, NY 10473-2008 - Phone
- (718) 863-4530
- Fax
- (718) 904-0073
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 213EP1101X | N003426 | NY | Primary |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | MD01710 | NJ |
Addresses
Primary practice location
2045 Lafayette Ave
Bronx, NY 10473-2008
Mailing address
2045 Lafayette Ave
Bronx, NY 10473-2008
Phone (718) 863-4530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003426 | NY | MD | Mental Health Counselor |
| MD01710 | NJ | MD | Primary Podiatric Medicine Podiatrist |
| N003426 | NY | MD | Primary Podiatric Medicine Podiatrist |
Interoperability endpoints
- tpenny680850@nychhc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376695361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2045 LAFAYETTE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104732008",
"telephone_number": "718-863-4530",
"fax_number": "718-904-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 LAFAYETTE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104732008",
"telephone_number": "718-863-4530",
"fax_number": "718-904-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNY",
"first_name": "THOMAS",
"middle_name": "R",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NY",
"license": "N003426",
"primary": true
},
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NJ",
"license": "MD01710",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.