Main Foot and Ankle Clinic LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

MAIN FOOT AND ANKLE CLINIC LLC

Practice address

1040 Main St
Floor 2
Paterson, NJ 07503-2212

Phone

(171) 898-6078

NPI assigned

Apr 12, 2013

Organization subpart

No

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

Authorized official

Name

Almutasemb Shehada, DPMNPI 1669737037

Title

Partner

Phone

(718) 986-0781

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 1

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

• Main Foot and Ankle Clinic LLC

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1588108583

  6507007911

  Same PAC ID

Locations

Practitioners 1

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

• Almutasemb M Shehada, PODIATRIST

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1669737037

  NJ, Primary Podiatric Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1386087997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MAIN ST",
            "address_2": "FLOOR 2",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032212",
            "telephone_number": "171-898-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MAIN ST",
            "address_2": "FLOOR 2",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032212",
            "telephone_number": "171-898-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "SHEHADA",
        "authorized_official_first_name": "ALMUTASEMB",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "17189860781",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Israi Mahmoud Mahgoub
• Shevani Mahindra
• Anas M Mahmoud, MD
• Maimon Care PC
• Main Chiro-Care Center PC
• Main Med Health
• Main Spine and Rehab LLC
• Main St. Optical LLC
• Main Street RX
• Maincare Infusion LLC

• Foot & Ankle Surgery Podiatrist in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.