NPIMap

Organization Active NPI

Family Foot Care of Long Island, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Port Jefferson Station, NY
National Provider Identifier
1629501556
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
106728 Issued in NY
Legal business name
FAMILY FOOT CARE OF LONG ISLAND, PLLC
Practice address
1 Medical Dr Ste B
Port Jefferson Station, NY 11776-1599
Phone
(631) 928-8383
Fax
(631) 928-8388
NPI assigned
Apr 7, 2017
Last updated
Aug 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Dr. Louis Macdonald, DPMNPI 1982605572
Title
Partner
Phone
(631) 928-8383

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
Durable Medical Equipment & Medical Supplies 332B00000X 106728 NY Primary

Addresses

Primary practice location

1 Medical Dr Ste B
Port Jefferson Station, NY 11776-1599

Mailing address

2 Medical Dr
Suite C
Port Jefferson Station, NY 11776-1598
Phone (631) 928-8383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170809000774 NY DME Supplier - Physician - Podiatry 5193002970 Practice locations: Port Jefferson Station, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Foot Care of Long Island PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1629501556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL DR",
            "address_2": "SUITE C",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761598",
            "telephone_number": "631-928-8383",
            "fax_number": "631-928-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL DR STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761599",
            "telephone_number": "631-928-8383",
            "fax_number": "631-928-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT CARE OF LONG ISLAND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-928-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "106728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.