Individual provider Active NPI

Panagiotis Panagakos, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Staten Island, NY
National Provider Identifier
1629211263
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
R64960 Issued in NY
Practice address
612 West Fingerboard Road
Staten Island, NY 10305
Phone
(718) 720-6113
NPI assigned
Apr 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X R64960 NY Primary

Addresses

Primary practice location

612 West Fingerboard Road
Staten Island, NY 10305

Mailing address

612 West Fingerboard Road
Staten Island, NY 10305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110518000413 NJ Practitioner - Podiatry 5294911707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Foot and Ankle AssociatesGroup PAC ID 5597755975, 4 clinicians

Practice addresses (Care Compare)

11 N Harrison St
Princeton, NJ 08540-3502
Phone (609) 924-1922

Merit-based Incentive Payment System (MIPS)

Final score
80.45 of 100Reported as individual
Quality
64.45
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue33
Removal of skin lesions31
Removal of nail tissue263
Removal or shaving of skin growth212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00308300NJMDFoot & Ankle Surgery Podiatrist
R64960NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Foot and Ankle Associates Foot & Ankle Surgery CurrentSince Jul 2, 2012 Accepting new patients
Princeton Foot and Ankle Associates PastSince Jul 2, 2012 Accepting new patients

Locations

11 N Harrison St
Princeton, NJ 08540
Phone (609) 924-1689

263 Princeton Hightstown Rd
#R
West Windsor, NJ 08550
Phone (609) 799-0043

263 Princeton Hightstown Rd
West Windsor, NJ 08550
Phone (609) 799-0043

Interoperability endpoints

  • Direct secure messaging: panagiotis.panagakos.1@17315.direct.athenahealth.com
  • Direct secure messaging: ppanagakos@princetonfoot.mdlogic.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/17315/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1629211263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 WEST FINGERBOARD ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 WEST FINGERBOARD ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10305",
            "telephone_number": "718-720-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANAGAKOS",
        "first_name": "PANAGIOTIS",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "R64960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.