Individual provider Active NPI

Georgia Theodora Xenophontos

  • Foot & Ankle Surgery Podiatrist
  • Manhasset, NY
National Provider Identifier
1396485264
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
007466 Issued in NY
Practice address
1165 Northern Blvd Ste 301
Manhasset, NY 11030-3048
Phone
(516) 365-4545
Fax
(516) 365-7111
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 007466 NY Primary

Addresses

Primary practice location

1165 Northern Blvd Ste 301
Manhasset, NY 11030-3048

Mailing address

1165 Northern Blvd
Manhasset, NY 11030-3039
Phone (515) 316-4545

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250522000339 NY Order and Referring Only - PodiatryPractitioner - Podiatry 1254850308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007466NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robyn Joseph, DPM, PC. Foot & Ankle Surgery Current Accepting new patients

Locations

1165 Northern Blvd
Manhasset, NY 11030
Phone (516) 627-0303

1165 Northern Blvd
Ste 301
Manhasset, NY 11030
Phone (516) 365-4545

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1396485264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303039",
            "telephone_number": "515-316-4545",
            "fax_number": "515-365-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 NORTHERN BLVD STE 301",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303048",
            "telephone_number": "516-365-4545",
            "fax_number": "516-365-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XENOPHONTOS",
        "first_name": "GEORGIA",
        "middle_name": "THEODORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "007466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.