South Shore Podiatry, PLLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

N006053-1 Issued in NY

Legal business name

SOUTH SHORE PODIATRY, PLLC

Practice address

20 Hicksville Rd
Suite 2
Massapequa, NY 11758-5819

Phone

(516) 744-0354

Fax

(855) 959-1613

NPI assigned

Jul 14, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Mital B Patel, DPMNPI 1053343871

Title

Podiatrist

Phone

(516) 590-7744

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Mital B. Patel, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Massapequa, NY
  • NPI 1053343871
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1457735094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HICKSVILLE RD",
            "address_2": "SUITE 2",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585819",
            "telephone_number": "516-744-0354",
            "fax_number": "855-959-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HICKSVILLE RD",
            "address_2": "SUITE 2",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585819",
            "telephone_number": "516-744-0354",
            "fax_number": "855-959-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-14",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MITAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "516-590-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N006053-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02669029",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A100127791",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PK6781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine M Sneddon, DPT
• Marla Sochet, LMT
• Shivanand N Sohan, LMSW
• Solisa LLC
• Mariaelena Soman, M.A., CCC-SLP, LBA
• Spa 505
• Brett Michael Spain, D.O.
• Domenica Elise Sparago, LPN
• Ryan Sparks
• Spiegel & Schild DMD,PLLC

• Foot Surgery Podiatrist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Foot Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.