Organization Active NPI

Edward Morreale DPM PC

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1508982836
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005019 Issued in NY
Legal business name
EDWARD MORREALE DPM PC
Practice address
405 Church Ave
Brooklyn, NY 11218-3107
Phone
(718) 437-9343
Fax
(718) 633-7352
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Authorized official

Name
Edward MorrealeNPI 1467542308
Title
Sole Proprietor
Phone
(718) 437-9343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N005019 NY Primary

Addresses

Primary practice location

405 Church Ave
Brooklyn, NY 11218-3107

Mailing address

405 Church Ave
Brooklyn, NY 11218-3107
Phone (718) 437-9343

Other identifiers 1

IdentifierTypeStateIssuer
01475332MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080814000475 NY Part B Supplier - Clinic/Group Practice 7214002914 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY
O20100930086670 NY DME Supplier - Physician - Podiatry 7214002914 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1508982836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183107",
            "telephone_number": "718-437-9343",
            "fax_number": "718-633-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183107",
            "telephone_number": "718-437-9343",
            "fax_number": "718-633-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD MORREALE DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "MORREALE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-437-9343"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01475332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.