Organization Active NPI

Greater Queens Podiatry PLLC

  • Foot Surgery Podiatrist
  • Bayside, NY
National Provider Identifier
1396911525
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
GREATER QUEENS PODIATRY PLLC
Practice address
4401 Francis Lewis Blvd
L3-B
Bayside, NY 11361-3002
Phone
(718) 229-0222
Fax
(718) 717-0275
NPI assigned
May 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Dr. Nicholas Megdanis, DPMNPI 1699851899
Title
Podiatrist
Phone
(718) 229-0222

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X Primary

Addresses

Primary practice location

4401 Francis Lewis Blvd
L3-B
Bayside, NY 11361-3002

Mailing address

PO Box 610406
Bayside, NY 11361-0406
Phone (718) 229-0222

Other identifiers 1

IdentifierTypeStateIssuer
01049958MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080814000453 NY Part B Supplier - Clinic/Group Practice 5698840395 Receives reassigned benefits from 2 practitioners
Practice locations: Bayside, NY
O20100930031645 NY DME Supplier - Physician - Podiatry 5698840395 Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1396911525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610406",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113610406",
            "telephone_number": "718-229-0222",
            "fax_number": "718-717-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 FRANCIS LEWIS BLVD",
            "address_2": "L3-B",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613002",
            "telephone_number": "718-229-0222",
            "fax_number": "718-717-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER QUEENS PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "MEGDANIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "718-229-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01049958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.