Fresh Pond Podiatry PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

FRESH POND PODIATRY PLLC

Practice address

6094 Putnam Ave
Ridgewood, NY 11385-4555

Phone

(718) 386-5100

NPI assigned

Dec 12, 2023

Organization subpart

No

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

Authorized official

Name

Vito Lapuma, DPMNPI 1790018059

Title

Owner

Phone

(718) 386-5100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vito La Puma, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
  • NPI 1790018059
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1457129207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6094 PUTNAM AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854555",
            "telephone_number": "718-386-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6094 PUTNAM AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854555",
            "telephone_number": "718-386-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 John St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100383101",
            "country_code": "US",
            "telephone_number": "212-791-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FRESH POND PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "LAPUMA",
        "authorized_official_first_name": "VITO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-386-5100",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Forste, M.A., CCC-SLP
• Freedom Star Medical Supplies Inc
• Fresh Pond Physical Therapy Greenpoint, P.C
• Fresh Pond Physical Therapy, P.C
• Fresh Pond Physical Therapy, P.C
• Fresh Pond RX Inc
• Fresh Smiles PLLC
• Friendly Connections Inc
• Sreenivasa R Gade II
• Clare Gagne, CLC

• Foot & Ankle Surgery Podiatrist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.