Individual provider Active NPI

Liliya Gumenik

  • Foot & Ankle Surgery Podiatrist
  • Fort Bragg, NC
National Provider Identifier
1457647661
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
006563 Issued in NY
Practice address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-4040
Phone
(910) 907-6000
Fax
(718) 228-5272
NPI assigned
Jun 27, 2011
Last updated
Jul 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 006563 NY
Primary Podiatric Medicine Podiatrist 213EP1101X 006563 NY
Foot & Ankle Surgery Podiatrist 213ES0103X 006563 NY Primary

Addresses

Primary practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-4040

Mailing address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-4184
Phone (910) 907-6000

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
I20140210001271 NY Practitioner - Podiatry 0840429098 Reassigns benefits to 6 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.01 of 100Reported as group
Quality
98.39
Promoting interoperability
100
Improvement activities
40
Cost
78.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006563NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients
Inna Petrosova Medical PC CurrentSince May 1, 2019 Accepting new patients
Intermed Care PC CurrentSince Jan 1, 2023 Accepting new patients
Century Medical & Dental Center Inc CurrentSince Feb 1, 2020 Accepting new patients
Seaview Podiatry P.C. CurrentSince Jan 1, 2021 Accepting new patients
Seaview Podiatry P.C. Podiatrist CurrentSince Jan 1, 2021 Accepting new patients
Manalapan Medical Center PA PC CurrentSince Sep 16, 2014 Accepting new patients
Suny Downstate Medical Center PastSince Feb 1, 2020 Accepting new patients

Locations

345 US Highway 9
Manalapan, NJ 07726
Phone (723) 272-4141

2233 Nostrand Ave
Brooklyn, NY 11210
Phone (718) 258-1714

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

3048 Brighton 1st St
Brooklyn, NY 11235
Phone (718) 368-1170

3048 Brighton 1st St
Ste 1
Brooklyn, NY 11235
Phone (718) 368-1170

770 Flatbush Ave
Brooklyn, NY 11226
Phone (347) 627-3988

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBIEBD

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1457647661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283104184",
            "telephone_number": "910-907-6000",
            "fax_number": "718-228-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283104040",
            "telephone_number": "910-907-6000",
            "fax_number": "718-228-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMENIK",
        "first_name": "LILIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2025-07-15",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "006563",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "006563",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.