Individual provider Active NPI

Devi G Enerio-Ellant, DPM

  • Podiatrist
  • New York, NY
National Provider Identifier
1659491892
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005634 Issued in NY
Practice address
773-775 9TH Avenue
New York, NY 10019-8856
Phone
(917) 991-4168
Fax
(212) 228-0879
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 005634 NY Primary

Addresses

Primary practice location

773-775 9TH Avenue
New York, NY 10019-8856

Mailing address

2 5TH Ave
Apt 8U
New York, NY 10011-8856
Phone (212) 228-0879

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
I20210917001801 NY Practitioner - Podiatry 8123425147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005634NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Forward Podiatry PC Podiatrist CurrentSince Jan 1, 2022 Accepting new patients

Locations

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

15 Canal Rd
Pelham, NY 10803
Phone (646) 362-4601

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

Organizations & group practices 1

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659491892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 5TH AVE",
            "address_2": "APT 8U",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118856",
            "telephone_number": "212-228-0879",
            "fax_number": "212-228-0879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773-775 9TH AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100198856",
            "telephone_number": "917-991-4168",
            "fax_number": "212-228-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENERIO-ELLANT",
        "first_name": "DEVI",
        "middle_name": "G",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.