Active NPI
John Draugel Kannengieser, D.P.M.
- Foot & Ankle Surgery Podiatrist
- West Islip, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 006700
- Practice address
- 1111 Montauk Hwy
Ste 100
West Islip, NY 11795-4910 - Phone
- (631) 422-4450
- NPI assigned
- Jul 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 006700 | NY | Primary |
Addresses
Primary practice location
1111 Montauk Hwy
Ste 100
West Islip, NY 11795-4910
Mailing address
1111 Montauk Hwy
Ste 100
West Islip, NY 11795-4910
Phone (631) 422-4450
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150401000738 | NY | Practitioner - Podiatry | 5597082578 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- New York College of Podiatric Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Island Foot and Ankle
Practice addresses (Care Compare)
1111 Montack Hwy
West Islip, NY 11795-4910
Phone (631) 422-4450
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 254 |
| Removal of skin lesions | 52 |
| Removal of nail tissue | 1809 |
| Removal or shaving of skin growth | 1816 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006700 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun River Health Inc. | Current | Accepting new patients | |
| Island Foot and Ankle | Foot & Ankle Surgery | Current | Accepting new patients |
| Island Foot and Ankle | Foot & Ankle Surgery | Current | Accepting new patients |
| Sun River Health Inc | Current | Accepting new patients |
Locations
3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006
207 Broadway
Amityville, NY 11701
Phone (631) 264-1910
1399 Franklin Ave
Ste 304
Garden City, NY 11530
Phone (516) 248-9680
1037 Main St
Peekskill, NY 10566
Phone (914) 734-8800
952 Roanoke Ave
Riverhead, NY 11901
Phone (631) 422-4450
30 Hempstead Ave
Ste 158
Rockville Ctr, NY 11570
Phone (516) 764-6800
6144 Route 25A
Ste 14
Wading River, NY 11792
Phone (631) 707-8771
1111 Montauk Hwy
West Islip, NY 11795
Phone (631) 422-2700
1111 Montauk Hwy
Ste 100
West Islip, NY 11795
Phone (631) 376-4163
Interoperability endpoints
- jkannengieser69124@northwell.direct-ci.com
Organizations & group practices 7
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.
-
- Foot & Ankle Surgery Podiatrist
- West Islip, NY
- NPI 1033410121
Foot & Ankle Surgery, NY
-
- Foot & Ankle Surgery Podiatrist
- Amityville, NY
- NPI 1164874459
-
- Foot & Ankle Surgery Podiatrist
- Riverhead, NY
- NPI 1346692639
-
- Foot & Ankle Surgery Podiatrist
- Wading River, NY
- NPI 1922665231
-
- Federally Qualified Health Center (FQHC)
- Peekskill, NY
- NPI 1619969458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1447515465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MONTAUK HWY",
"address_2": "STE 100",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954910",
"telephone_number": "631-422-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MONTAUK HWY",
"address_2": "STE 100",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954910",
"telephone_number": "631-422-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANNENGIESER",
"first_name": "JOHN",
"middle_name": "DRAUGEL",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-05",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "006700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.