Individual provider Active NPI

Nachum Pelcovitz, D.P.M.

  • Podiatrist
  • Lawrence, NY
National Provider Identifier
1619975943
Registry record updated Nov 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N3598 Issued in NY
Practice address
183 Wildacre Ave
Lawrence, NY 11559-1414
Phone
(516) 239-8300
Fax
(516) 371-9418
NPI assigned
Jul 11, 2005
Last updated
Nov 3, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N3598 NY Primary
Podiatrist 213E00000X 25MD00179200 NJ
Podiatrist 213E00000X P00384 CT

Addresses

Primary practice location

183 Wildacre Ave
Lawrence, NY 11559-1414

Mailing address

183 Wildacre Ave
Lawrence, NY 11559-1414
Phone (516) 239-8300

Other identifiers 2

IdentifierTypeStateIssuer
0586102MedicaidNJ
00792609MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040527001237 NJ Practitioner - Podiatry 8325029010 Reassigns benefits to 3 organizations
I20040608000376 NY Practitioner - Podiatry 8325029010 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000384CTMDMental Health Counselor
003598NYMDOptometrist
N3598NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Company LLC Podiatrist CurrentSince Jan 1, 2012 Accepting new patients
Medical Director Services PC CurrentSince Aug 29, 2023 Accepting new patients
Vainstein Foot and Ankle Care, PC Podiatrist Past Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Past Accepting new patients

Locations

930 Mill Hill Ter
Southport, CT 06890
Phone (203) 259-7894

43 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-3100

620 Sleepy Hollow Rd
Briarcliff Manor, NY 10510
Phone (800) 501-3936

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

301 Mill Rd
Ste U7
Hewlett, NY 11557

193 S Union Rd
Williamsville, NY 14221
Phone (716) 276-1900

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, 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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194048000000",
    "number": "1619975943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 WILDACRE AVE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591414",
            "telephone_number": "516-239-8300",
            "fax_number": "516-371-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 WILDACRE AVE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591414",
            "telephone_number": "516-239-8300",
            "fax_number": "516-371-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELCOVITZ",
        "first_name": "NACHUM",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2007-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N3598",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00179200",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "P00384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0586102",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00792609",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

Verify at the official NPI Registry.