NPIMap

Organization Active NPI

Innovative Footcare P.C

  • Podiatrist
  • Bronx, NY
National Provider Identifier
1689795890
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003762 Issued in NY
Legal business name
INNOVATIVE FOOTCARE P.C
Practice address
391 E 149TH St
Bronx, NY 10455-3907
Phone
(718) 292-7081
NPI assigned
Apr 3, 2007
Last updated
Sep 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Dr. Robert Matthew Locastro, DPMNPI 1982606323
Title
Doctor
Phone
(718) 292-7081

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004738 NY
Podiatrist 213E00000X N005916 NY
Podiatrist 213E00000X N003762 NY Primary

Addresses

Primary practice location

391 E 149TH St
Bronx, NY 10455-3907

Mailing address

391 E 149TH St
Bronx, NY 10455-3907
Phone (718) 292-7081

Other identifiers 1

IdentifierTypeStateIssuer
00873914MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050820000065 NY Part B Supplier - Clinic/Group Practice 1052341856 Receives reassigned benefits from 5 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

391 E 149th St
Bronx, NY 10455
Phone (646) 702-6965

Practitioners & affiliated clinicians

Practitioners 8

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1689795890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553907",
            "telephone_number": "718-292-7081",
            "fax_number": "718-292-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553907",
            "telephone_number": "718-292-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE FOOTCARE P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "LOCASTRO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-292-7081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004738",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005916",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00873914",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.