Organization Active NPI

New York Podiatry Care PLLC

  • Foot & Ankle Surgery Podiatrist
  • Long Beach, NY
National Provider Identifier
1710379581
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N006663-1 Issued in NY
Legal business name
NEW YORK PODIATRY CARE PLLC
Practice address
756 E Park Ave
Long Beach, NY 11561-2605
Phone
(516) 432-7470
NPI assigned
Mar 3, 2015
Last updated
Apr 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Authorized official

Name
Sarah Kim, DPMNPI 1831539501
Title
Physician/ Owner
Phone
(206) 694-3625

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
Foot & Ankle Surgery Podiatrist 213ES0103X N006663-1 NY Primary

Addresses

Primary practice location

756 E Park Ave
Long Beach, NY 11561-2605

Mailing address

756 E Park Ave
Long Beach, NY 11561-2605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150603000813 NY Part B Supplier - Clinic/Group Practice 5496076432 Receives reassigned benefits from 1 practitioner
Practice locations: Long Beach, NY

National Provider Directory

National Provider Directory

Locations

756 E Park Ave
Long Beach, NY 11561
Phone (206) 694-3625

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": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1710379581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612605",
            "telephone_number": "516-432-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PODIATRY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PHYSICIAN/ OWNER",
        "authorized_official_telephone_number": "206-694-3625",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006663-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.