Organization Active NPI

Advanced Westchester Podiatry LLP

  • Foot & Ankle Surgery Podiatrist
  • Mohegan Lake, NY
National Provider Identifier
1629266960
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ADVANCED WESTCHESTER PODIATRY LLP
Practice address
1990 E Main St
Mohegan Lake, NY 10547-1231
Phone
(914) 743-1066
Fax
(914) 743-1067
NPI assigned
Oct 11, 2007
Last updated
Dec 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Dr. Dennis S Nachmann, DPMNPI 1174516355
Title
President
Phone
(914) 743-1066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1990 E Main St
Mohegan Lake, NY 10547-1231

Mailing address

1990 E Main St
Mohegan Lake, NY 10547-1231
Phone (914) 743-1066

Other identifiers 1

IdentifierTypeStateIssuer
02049892MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071029000380 NY Part B Supplier - Clinic/Group Practice 2466549126 Receives reassigned benefits from 1 practitioner
Practice locations: Mohegan Lake, NY

National Provider Directory

National Provider Directory

Locations

1990 E Main St
Mohegan Lake, NY 10547
Phone (914) 743-1066

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1629266960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 E MAIN ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471231",
            "telephone_number": "914-743-1066",
            "fax_number": "914-743-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 E MAIN ST",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471231",
            "telephone_number": "914-743-1066",
            "fax_number": "914-743-1067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WESTCHESTER PODIATRY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "NACHMANN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-743-1066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02049892",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mohegan Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.