Organization Active NPI

Personalized Footcare PC

  • Foot & Ankle Surgery Podiatrist
  • Yonkers, NY
National Provider Identifier
1417980459
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N005916 Issued in NY
Legal business name
PERSONALIZED FOOTCARE PC
Practice address
970 N Broadway
308B
Yonkers, NY 10701-1309
Phone
(914) 423-8000
NPI assigned
Jul 9, 2006
Last updated
Jul 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Dr. Avraham Yitzchak Ciment, DPMNPI 1578557625
Title
Ceo
Phone
(646) 496-8853

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 & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X N005916 NY Primary

Addresses

Primary practice location

970 N Broadway
308B
Yonkers, NY 10701-1309

Mailing address

333 Oakford St
West Hempstead, NY 11552-3220
Phone (516) 485-3021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000156 NY Part B Supplier - Clinic/Group Practice 8527166651 Receives reassigned benefits from 6 practitioners
Practice locations: Hempstead, NY; Hewlett, NY; Ilion, NY; Island Park, NY; Jamaica, NY; Lawrence, NY; Pawling, NY; Poughkeepsie, NY…

National Provider Directory

National Provider Directory

Locations

3130 Grand Concourse
Bronx, NY 10458
Phone (718) 365-7255

1125 W Broadway
Hewlett, NY 11557

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1417980459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 OAKFORD ST",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523220",
            "telephone_number": "516-485-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N BROADWAY",
            "address_2": "308B",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011309",
            "telephone_number": "914-423-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED FOOTCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "CIMENT",
        "authorized_official_first_name": "AVRAHAM",
        "authorized_official_middle_name": "YITZCHAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-496-8853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N005916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.