Individual provider Active NPI

Michael J. Brunetti, D.P.M.

  • Podiatrist
  • New York, NY
National Provider Identifier
1609962224
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005063-1 Issued in NY
Practice address
305 East 86TH Street
Suite 1GW
New York, NY 10028-4702
Phone
(212) 534-9393
Fax
(212) 534-9397
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N005063-1 NY Primary

Addresses

Primary practice location

305 East 86TH Street
Suite 1GW
New York, NY 10028-4702

Mailing address

423 East 75TH Street
New York, NY 10021-3119
Phone (212) 534-9393

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
I20100819000901 NY Practitioner - Podiatry 8527192939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J Brunetti DPM PCGroup PAC ID 5597957555, 2 clinicians

Practice addresses (Care Compare)

305 E 86TH St
Apt 1GW
New York, NY 10028-4712
Phone (212) 534-9393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions23
Removal of nail tissue51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005063-1NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Brunetti, D.P.M., P.C. Podiatrist CurrentSince Jan 1, 1998 Accepting new patients

Locations

423 E 75th St
Bsmt
New York, NY 10021

423 E 75th St
New York, NY 10021
Phone (212) 241-3699

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609962224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 EAST 75TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213119",
            "telephone_number": "212-534-9393",
            "fax_number": "212-534-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 EAST 86TH STREET",
            "address_2": "SUITE 1GW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100284702",
            "telephone_number": "212-534-9393",
            "fax_number": "212-534-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNETTI",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005063-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.