Individual provider Active NPI

Gary Kantrowitz, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Kew Gardens, NY
National Provider Identifier
1629144506
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
N003508 Issued in NY
Practice address
11940 Metropolitan Ave
Kew Gardens, NY 11415-2600
Phone
(516) 551-3303
Fax
(212) 644-2111
NPI assigned
Nov 24, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X N003508 NY Primary

Addresses

Primary practice location

11940 Metropolitan Ave
Kew Gardens, NY 11415-2600

Mailing address

11940 Metropolitan Ave
Kew Gardens, NY 11415-2600
Phone (516) 551-3303

Other identifiers 1

IdentifierTypeStateIssuer
00939942MedicaidNY

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
I20040607000227 NY Practitioner - Podiatry 2466434097 Reassigns benefits to 1 organization
Practice locations: Far Rockaway, NY; Kew Gardens, NY; New York, NY

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N003508NYMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jay Bienenfeld DPM PLLC CurrentSince Aug 11, 2020 Accepting new patients
Dac Physician Services,PC PastSince May 3, 2004 Accepting new patients

Locations

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1629144506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 METROPOLITAN AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152600",
            "telephone_number": "516-551-3303",
            "fax_number": "212-644-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 METROPOLITAN AVE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152600",
            "telephone_number": "516-551-3303",
            "fax_number": "212-644-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTROWITZ",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N003508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00939942",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

Verify at the official NPI Registry.