NPIMap

Organization Active NPI

Advanced Podiatry of Manhasset, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Manhasset, NY
National Provider Identifier
1669626370
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
005950 Issued in NY
Legal business name
ADVANCED PODIATRY OF MANHASSET, PLLC
Practice address
2110 Northern Blvd Ste 208
Manhasset, NY 11030-3500
Phone
(516) 869-3300
Fax
(516) 484-4229
NPI assigned
Nov 7, 2008
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Dr. Pedram A Hendizadeh, D.P.M.NPI 1780786517
Title
Owner
Phone
(516) 869-3300

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
Foot & Ankle Surgery Podiatrist 213ES0103X 005950 NY Primary

Addresses

Primary practice location

2110 Northern Blvd Ste 208
Manhasset, NY 11030-3500

Mailing address

2110 Northern Blvd Ste 208
Manhasset, NY 11030-3500
Phone (516) 869-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081210000316 NY Part B Supplier - Clinic/Group Practice 6406917343 Receives reassigned benefits from 20 practitioners
Practice locations: Baldwin, NY; Coram, NY; Huntington, NY; Manhasset, NY; Maspeth, NY; Ronkonkoma, NY; Woodbury, NY
O20100930023432 NY DME Supplier - Physician - Podiatry 6406917343 Practice locations: Manhasset, NY

National Provider Directory

National Provider Directory

Locations

181 Main St
Ste 207
Huntington, NY 11743
Phone (516) 869-3300

1514 Old Northern Blvd
Roslyn, NY 11576
Phone (516) 484-1420

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1669626370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD STE 208",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303500",
            "telephone_number": "516-869-3300",
            "fax_number": "516-484-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD STE 208",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303500",
            "telephone_number": "516-869-3300",
            "fax_number": "516-484-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PODIATRY OF MANHASSET, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-07",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "HENDIZADEH",
        "authorized_official_first_name": "PEDRAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-869-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "005950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.