Organization Active NPI

E Youngewirth DPM PLLC

  • Foot Surgery Podiatrist
  • New York, NY
National Provider Identifier
1699945030
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
E YOUNGEWIRTH DPM PLLC
Practice address
4915 Broadway
New York, NY 10034-3119
Phone
(212) 567-6126
NPI assigned
Feb 29, 2008
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Brian Flores
Title
Credentialing Specialist
Phone
(718) 313-0438

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4915 Broadway
New York, NY 10034-3119

Mailing address

4915 Broadway
New York, NY 10034-3119
Phone (212) 567-6126

Other names 1

  • ELIZABETH YOUNGEWIRTH DPM PLLC Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930071629 NY DME Supplier - Physician - Podiatry 1759402225 Practice locations: New York, NY
O20120202000365 NY Part B Supplier - Clinic/Group Practice 1759402225 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY; Suffern, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1699945030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343119",
            "telephone_number": "212-567-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343119",
            "telephone_number": "212-567-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E YOUNGEWIRTH DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "718-313-0438"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELIZABETH YOUNGEWIRTH DPM PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.