Individual provider Active NPI

Clifford J Toback, DPM

  • Podiatrist
  • New Windsor, NY
National Provider Identifier
1558338301
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003616 Issued in NY
Practice address
388 Blooming Grove Tpke
New Windsor, NY 12523
Phone
(845) 561-1255
Fax
(845) 561-4033
NPI assigned
Mar 1, 2006
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N003616 NY Primary

Addresses

Primary practice location

388 Blooming Grove Tpke
New Windsor, NY 12523

Mailing address

103 Hurley Avenue
Kingston, NY 12401
Phone (845) 339-4191

Other identifiers 1

IdentifierTypeStateIssuer
01627494MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N003616NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter PastSince Oct 12, 2015 Accepting new patients
Hudson Valley Health Specialties, Inc Past Accepting new patients

Organizations & group practices 2

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1558338301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 HURLEY AVENUE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-339-4191",
            "fax_number": "845-339-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "12523",
            "telephone_number": "845-561-1255",
            "fax_number": "845-561-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBACK",
        "first_name": "CLIFFORD",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01627494",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.