Individual provider Active NPI

John William Fletcher, DPM

  • Foot & Ankle Surgery Podiatrist
  • New York, NY
National Provider Identifier
1508124447
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006623 Issued in NY
Practice address
1090 Amsterdam Ave
10C
New York, NY 10025-1737
Phone
(212) 845-9991
NPI assigned
Apr 29, 2012
Last updated
Jul 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X N006623 NY Primary

Addresses

Primary practice location

1090 Amsterdam Ave
10C
New York, NY 10025-1737

Mailing address

1090 Amsterdam Ave
10C
New York, NY 10025-1737

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
I20150507000429 NY Practitioner - Podiatry 2961721386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1080 Amsterdam Ave
Apt 101
New York, NY 10025-8099
Phone (646) 558-2248

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue301
Removal or shaving of skin growth125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N006623NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Morningside Podiatry PLLC Foot & Ankle Surgery CurrentSince Jun 12, 2023 Accepting new patients

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/IGHEBA/Endpoint/IGHEBA

Organizations & group practices 1

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": "1335657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1508124447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "address_2": "10C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "address_2": "10C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-845-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-29",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.