Organization Active NPI

Highway Podiatry PC

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1659973162
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
HIGHWAY PODIATRY PC
Practice address
2424 Kings Hwy
Brooklyn, NY 11229-1669
Phone
(718) 258-9572
NPI assigned
Nov 10, 2020
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Jacob WallachNPI 1154437358
Title
DPM
Phone
(718) 258-9572

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
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

2424 Kings Hwy
Brooklyn, NY 11229-1669

Mailing address

51 White Dr
Cedarhurst, NY 11516-2630

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210206000024 NY Part B Supplier - Clinic/Group Practice 9537572201 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2424 Kings Hwy
Ste 1G
Brooklyn, NY 11229
Phone (718) 258-9572

Practitioners & affiliated clinicians

Practitioners 3

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": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1659973162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WHITE DR",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291669",
            "telephone_number": "718-258-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHWAY PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "WALLACH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "718-258-9572"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.