Active NPI
Theodore Franklin Merletti, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Niagara Falls, NY
National Provider Identifier
1669411864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- N003956-1
- Practice address
- 616 Pine Ave
Niagara Falls, NY 14301-1754 - Phone
- (716) 284-2242
- Fax
- (716) 205-0012
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | N003956-1 | NY | Primary |
Addresses
Primary practice location
616 Pine Ave
Niagara Falls, NY 14301-1754
Mailing address
616 Pine Ave
Niagara Falls, NY 14301-1754
Phone (716) 284-2242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01220942 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N003956-1 | NY | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1669411864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 PINE AVE",
"city": "NIAGARA FALLS",
"state": "NY",
"postal_code": "143011754",
"telephone_number": "716-284-2242",
"fax_number": "716-205-0012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 PINE AVE",
"city": "NIAGARA FALLS",
"state": "NY",
"postal_code": "143011754",
"telephone_number": "716-284-2242",
"fax_number": "716-205-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERLETTI",
"first_name": "THEODORE",
"middle_name": "FRANKLIN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NY",
"license": "N003956-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01220942",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Niagara Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.