Shibu Kinatukara, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

NOO5595 Issued in NY

Practice address

1640 Ocean Ave
Suite 1B
Brooklyn, NY 11230-4963

Phone

(718) 258-4100

Fax

(718) 251-1856

NPI assigned

May 3, 2006

Last updated

Jun 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brooklyn Footcare, P.C.

  • Podiatrist
  • Brooklyn, NY
  • NPI 1710329248
  Medicare reassignment NPD Authorized official
• Marc a. Brenner

  • Podiatrist
  • Brooklyn, NY
  • NPI 1427352723

  Foot & Ankle Surgery

  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1386602027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 RALPH AVE STE 418",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345416",
            "telephone_number": "718-258-4100",
            "fax_number": "718-251-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 OCEAN AVE",
            "address_2": "SUITE 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304963",
            "telephone_number": "718-258-4100",
            "fax_number": "718-251-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINATUKARA",
        "first_name": "SHIBU",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "NOO5595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Victor Carino Kimpo, DO
• Toni Kimpson, LMSW
• Maria Kinani, PHARMD.
• John Kinard, CASAC
• Saima Kinatukara
• Ramon Kincade
• Dejuan Lee Kinchelow, MD
• Miasya Kinchelow
• Kind Heart Home Care LLC
• Kind Mental Health Counseling PLLC (Our Kind Therapy)

• Foot & Ankle Surgery Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.