Active NPI
Maria Ellise Natividad, DPM
- Foot & Ankle Surgery Podiatrist
- Northport, NY
National Provider Identifier
1477849529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 390200000X
- Practice address
- 79 Middleville Rd
Northport, NY 11768-2200 - Phone
- (631) 261-4400
- NPI assigned
- Jun 27, 2011
- Sex
- Female
- 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 | 390200000X | NY | Primary |
Addresses
Primary practice location
79 Middleville Rd
Northport, NY 11768-2200
Mailing address
PO Box 201
Northport, NY 11768-0201
Phone (254) 495-9891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | NY | MD | Student in an Organized Health Care Education/Training Program |
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": "1309132800000",
"number": "1477849529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 201",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117680201",
"telephone_number": "254-495-9891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 MIDDLEVILLE RD",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117682200",
"telephone_number": "631-261-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NATIVIDAD",
"first_name": "MARIA",
"middle_name": "ELLISE",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-27",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.