Active NPI
Jiri Podany
- Specialist
- Floral Park, NY
National Provider Identifier
1508845694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 116661
- Practice address
- 99 Verbena Ave
Floral Park, NY 11001-3014 - Phone
- (516) 775-4642
- NPI assigned
- Jan 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 116661 | NY | Primary |
Addresses
Primary practice location
99 Verbena Ave
Floral Park, NY 11001-3014
Mailing address
99 Verbena Ave
Floral Park, NY 11001-3014
Phone (516) 775-4642
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00865027 | Medicaid | NY |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110309000386 | NY | Practitioner - Gastroenterology | 4688856867 | Practice locations: Floral Park, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116661 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wholesome Medical PC | Past | Accepting new patients |
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 and National Provider Directory roles.
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- New Hyde Park, NY
- NPI 1194995670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1508845694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 VERBENA AVE",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110013014",
"telephone_number": "516-775-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 VERBENA AVE",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110013014",
"telephone_number": "516-775-4642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PODANY",
"first_name": "JIRI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "116661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00865027",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Floral Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.