Individual provider Active NPI

Theodore Franklin Merletti, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Niagara Falls, NY
National Provider Identifier
1669411864
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N003956-1 Issued in NY
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

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01220942MedicaidNY

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

LicenseStateTypeSpecialty
N003956-1NYMDFoot & 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.

Verify at the official NPI Registry.