Steven B Axt, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N003178 Issued in NY

Practice address

4 Phyllis Dr
Suite A3
Patchogue, NY 11772-2900

Phone

(631) 475-3030

Fax

(631) 475-3036

NPI assigned

Jul 12, 2005

Reactivated

Mar 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1497753693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MINEOLA BLVD",
            "address_2": "STE 201",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012530",
            "telephone_number": "631-475-3030",
            "fax_number": "631-475-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PHYLLIS DR",
            "address_2": "SUITE A3",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722900",
            "telephone_number": "631-475-3030",
            "fax_number": "631-475-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXT",
        "first_name": "STEVEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2018-11-05",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480000381",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.