Northport Podiatry PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N005219 Issued in NY

Legal business name

NORTHPORT PODIATRY PC

Practice address

1032 Fort Salonga Rd
Northport, NY 11768-2208

Phone

(631) 754-3338

Fax

(631) 754-3367

NPI assigned

Mar 25, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Denise G Raio, D.P.M.

Title

Owner/Podiatrist

Phone

(631) 754-3338

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Denise G Casinover-Raio, DPM

  • Podiatrist
  • Northport, NY
  • NPI 1639162118
  Medicare reassignment NPD

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1679745103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682208",
            "telephone_number": "631-754-3338",
            "fax_number": "631-754-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682208",
            "telephone_number": "631-754-3338",
            "fax_number": "631-754-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHPORT PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "RAIO",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "631-754-3338",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N005219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W3P441",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480034015",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01573528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northport Vamc
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• Northport Vamc

• Foot & Ankle Surgery Podiatrist in Northport, NY
• Providers in Northport, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.