Organization Active NPI

Brooklyn Footcare, P.C.

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1710329248
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005595 Issued in NY
Legal business name
BROOKLYN FOOTCARE, P.C.
Practice address
1899 Rockaway Pkwy
Brooklyn, NY 11236-5307
Phone
(718) 251-1122
Fax
(718) 251-1856
NPI assigned
Jul 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Dr. Shibu George Kinatukara, DPMNPI 1386602027
Title
DPM
Phone
(718) 251-1122

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X N005595 NY Primary

Addresses

Primary practice location

1899 Rockaway Pkwy
Brooklyn, NY 11236-5307

Mailing address

1899 Rockaway Pkwy
Brooklyn, NY 11236-5307
Phone (718) 251-1122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150225001512 NY Part B Supplier - Clinic/Group Practice 9537485131 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1977 Ralph Ave
Brooklyn, NY 11234

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1710329248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365307",
            "telephone_number": "718-251-1122",
            "fax_number": "718-251-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365307",
            "telephone_number": "718-251-1122",
            "fax_number": "718-251-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN FOOTCARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "KINATUKARA",
        "authorized_official_first_name": "SHIBU",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "718-251-1122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.