Organization Active NPI

Mobile Podiatry PC

  • Podiatrist
  • Jamaica, NY
National Provider Identifier
1396227617
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MOBILE PODIATRY PC
Practice address
14845 Hillside Ave FL 1
Jamaica, NY 11435-3308
Phone
(516) 476-1641
NPI assigned
Sep 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
M NayeemNPI 1013441252
Title
DPM
Phone
(516) 476-1641

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Podiatric Clinic/Center 261QP1100X 005189 NY

Addresses

Primary practice location

14845 Hillside Ave FL 1
Jamaica, NY 11435-3308

Mailing address

14845 Hillside Ave FL 1
Jamaica, NY 11435-3308
Phone (516) 476-1641

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181003003218 NY Part B Supplier - Clinic/Group Practice 2668724568 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Locations

14845 Hillside Ave
Fl 1
Jamaica, NY 11435
Phone (516) 476-1641

Practitioners & affiliated clinicians

Practitioners 4

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": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1396227617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14845 HILLSIDE AVE FL 1",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353308",
            "telephone_number": "516-476-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14845 HILLSIDE AVE FL 1",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353308",
            "telephone_number": "516-476-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "NAYEEM",
        "authorized_official_first_name": "M",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "516-476-1641"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NY",
            "license": "005189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.