Active NPI
David Sacrestano, D.P.M.
- Podiatrist
- Great Neck, NY
National Provider Identifier
1700062635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N006203
- Practice address
- 935 Northern Blvd
Suite 107
Great Neck, NY 11021-5316 - Phone
- (516) 627-5775
- Fax
- (516) 627-6259
- NPI assigned
- Jan 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N006203 | NY | Primary |
Addresses
Primary practice location
935 Northern Blvd
Suite 107
Great Neck, NY 11021-5316
Mailing address
935 Northern Blvd
Suite 107
Great Neck, NY 11021-5316
Phone (516) 627-5775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N006203 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Footluxe of Long Island Podiatry PC | Current | Accepting new patients | |
| Comprehensive Podiatric Care LLC | Podiatrist | Current | Accepting new patients |
Locations
474 Westbury Ave
Carle Place, NY 11514
Phone (516) 536-3336
935 Northern Blvd
Ste 107
Great Neck, NY 11021
Phone (516) 627-5775
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Podiatrist
- Great Neck, NY
- NPI 1588751119
-
- Foot & Ankle Surgery Podiatrist
- Carle Place, NY
- NPI 1922690056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199923200000",
"number": "1700062635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 NORTHERN BLVD",
"address_2": "SUITE 107",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215316",
"telephone_number": "516-627-5775",
"fax_number": "516-627-6259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 NORTHERN BLVD",
"address_2": "SUITE 107",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215316",
"telephone_number": "516-627-5775",
"fax_number": "516-627-6259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACRESTANO",
"first_name": "DAVID",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-10",
"last_updated": "2008-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N006203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.