Individual provider Active NPI

Jeanne Mary Courbis, D.P.M.

  • Foot Surgery Podiatrist
  • Commack, NY
National Provider Identifier
1609892389
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
006166 Issued in NY
Practice address
6143 Jericho Tpke
Suite 102
Commack, NY 11725-2852
Phone
(631) 864-7380
Fax
(631) 864-7381
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 006166 NY Primary

Addresses

Primary practice location

6143 Jericho Tpke
Suite 102
Commack, NY 11725-2852

Mailing address

6143 Jericho Tpke
Suite 102
Commack, NY 11725-2852
Phone (631) 864-7380

Other identifiers 1

IdentifierTypeStateIssuer
02832740MedicaidNY

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
I20060929000265 NY Practitioner - Podiatry 1052316098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1810 Union Blvd
Bay Shore, NY 11706-7923
Phone (631) 968-5600

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1355
Removal or shaving of skin growth606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Image Podiatry P.C. Foot Surgery CurrentSince Aug 18, 2006 Accepting new patients
Optimum Podiatry Group PLLC CurrentSince Apr 28, 2024 Accepting new patients
Hilltop Medical Diagnostic and Treatment Center Past Accepting new patients
Lifeco Medical, P.C. Past Accepting new patients
BBB Health Resources LLC Past Accepting new patients
North Shore-Lij Medical PC PastSince Apr 28, 2024 Accepting new patients

Locations

6143 Jericho Tpke
Ste 302
Commack, NY 11725
Phone (631) 864-7380

6143 Jericho Tpke
Ste 102
Commack, NY 11725
Phone (631) 864-7380

26619 Union Tpke
New Hyde Park, NY 11040
Phone (718) 347-0434

Interoperability endpoints

  • Direct secure messaging: jeannecourbis@nip.allscriptsdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1609892389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 JERICHO TPKE",
            "address_2": "SUITE 102",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252852",
            "telephone_number": "631-864-7380",
            "fax_number": "631-864-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 JERICHO TPKE",
            "address_2": "SUITE 102",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252852",
            "telephone_number": "631-864-7380",
            "fax_number": "631-864-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURBIS",
        "first_name": "JEANNE",
        "middle_name": "MARY",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "006166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02832740",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.