Individual provider Active NPI

John T Sottile, DPM

  • Podiatrist
  • Staten Island, NY
National Provider Identifier
1639274012
Registry record updated Aug 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004912 Issued in NY
Practice address
89 Cromwell Ave
Staten Island, NY 10304-3944
Phone
(718) 980-0126
NPI assigned
Sep 13, 2006
Last updated
Aug 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004912 NY Primary

Addresses

Primary practice location

89 Cromwell Ave
Staten Island, NY 10304-3944

Mailing address

89 Cromwell Ave
Staten Island, NY 10304-3944
Phone (718) 980-0126

Other identifiers 2

IdentifierTypeStateIssuer
P55503OtherBLUE CROSS BLUE SHIELD
017859375MedicaidNY

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
I20040429000216 NY Practitioner - Podiatry 1456348655 Reassigns benefits to 2 organizations
Practice locations: Staten Island, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (212) 434-6980

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue86
Removal of skin lesions1-10
Removal of nail tissue81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004912NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Feb 14, 2013 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Feb 14, 2013 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jsottile29062@northwell.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345161600000",
    "number": "1639274012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 CROMWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043944",
            "telephone_number": "718-980-0126",
            "fax_number": "718-980-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 CROMWELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043944",
            "telephone_number": "718-980-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTTILE",
        "first_name": "JOHN",
        "middle_name": "T",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P55503",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017859375",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.