Organization Active NPI

Foot Forward Podiatry PC

  • Podiatrist
  • Staten Island, NY
National Provider Identifier
1487314332
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT FORWARD PODIATRY PC
Practice address
260 Christopher LN Ste 102a
Staten Island, NY 10314-1631
Phone
(646) 921-0907
Fax
(315) 612-9793
NPI assigned
Dec 20, 2021
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Carolina Henriquez
Title
Director of Operations
Phone
(646) 921-0907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

260 Christopher LN Ste 102a
Staten Island, NY 10314-1631

Mailing address

20980 Cipres Way
Boca Raton, FL 33433-1604
Phone (646) 921-0907

Other practice location 1

1276 Hanover St
Manchester, NH 03104-5623
Phone (718) 362-8184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, VA, MA, NH, VT, CT7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20220110000374 NY Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 39 practitioners
Practice locations: Far Rockaway, NY; Syracuse, NY; Valley Cottage, NY
O20220112000051 NJ Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 23 practitioners
Practice locations: Trenton, NJ; Williamstown, NJ; Voorhees, NJ; Union City, NJ; Newark, NJ; Little Egg Harbor TWP, NJ; Lincoln Park, NJ; Hackensack, NJ…
O20221107001730 VA Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 5 practitioners
Practice locations: Virginia Beach, VA; Nassawadox, VA; Suffolk, VA; Roanoke, VA; Norfolk, VA; Newport News, VA; Harrisonburg, VA
O20221209001459 MA Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 1 practitioner
Practice locations: Brockton, MA; Somerset, MA; Saugus, MA; Norwood, MA; Fall River, MA; Danvers, MA; Arlington, MA; Amesbury, MA
O20230306001139 NH Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 2 practitioners
Practice locations: Epsom, NH; Manchester, NH
O20230602001829 VT Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 1 practitioner
Practice locations: Colchester, VT; Burlington, VT
O20260415000264 CT Part B Supplier - Clinic/Group Practice 3971995697 Receives reassigned benefits from 2 practitioners
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Locations

2601 E Evesham Rd
Voorhees, NJ 08043
Phone (856) 596-1113

260 Christopher Ln
Ste 102A
Staten Island, NY 10314
Phone (914) 370-4892

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

918 James St
#13282
Syracuse, NY 13203

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1487314332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20980 CIPRES WAY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334331604",
            "telephone_number": "646-921-0907",
            "fax_number": "315-612-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CHRISTOPHER LN STE 102A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141631",
            "telephone_number": "646-921-0907",
            "fax_number": "315-612-9793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 Hanover St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031045623",
            "country_code": "US",
            "telephone_number": "718-362-8184",
            "fax_number": "718-414-1651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOT FORWARD PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "HENRIQUEZ",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "646-921-0907"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.