Active NPI
Christopher Kent Bromley, DPM
- Podiatrist
- Poughkeepsie, NY
National Provider Identifier
1710926340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 65 004988
- Practice address
- 22 Fairmont Ave
Poughkeepsie, NY 12603-2422 - Phone
- (845) 454-0630
- Fax
- (845) 454-0637
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 65 004988 | NY | Primary |
Addresses
Primary practice location
22 Fairmont Ave
Poughkeepsie, NY 12603-2422
Mailing address
243 North Rd Ste 304
Poughkeepsie, NY 12601-1173
Phone (845) 471-9410
Other identifiers 25
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1793752 | Other | NYS EMPIRE PLAN UNITED HEALTHCARE LEGACY NUMBER | |
| 1C8554 | Other | PHS LEGACY NUMBER | |
| 000405793008 | Other | BSNENY LEGACY NUMBER | |
| 01515315 | Medicaid | NY | |
| 10032229 | Other | CDPHP LEGACY NUMBER | |
| 200053170 | Other | MVP HEALTH PLAN GROUP LEGACY NUMBER | |
| 39099 | Other | GHI HMO SELECT LEGACY NUMBER | |
| 953501 | Other | MVP HEALTH PLAN LEGACY NUMBER | |
| 408871001 | Other | BSNENY GROUP LEGACY NUMBER | |
| 505870 | Other | AETNA US LEGACY NUMBER | |
| 6200857 | Other | GHI LEGACY NUMBER | |
| 139099 | Other | WELLCARE LEGACY NUMBER | |
| 30061 | Other | LAST 5 TIN | |
| P82109 | Other | SECURE HORIZONS LEGACY NUMBER | |
| P821809B | Other | OXFORD HEALTH CARE LEGACY NUMBER | |
| 100107789201 | Other | UNITED HEALTHCARE LEGACY NUMBER | |
| 1235164997 | Other | GROUP PRACTICE NPI | |
| 1793752 | Other | UNITED HEALTHCARE GROUP LEGACY NUMBER | |
| 200053170 | Other | MVP HEALTHCARE GROUP LEGACY NUMBER | |
| 33D0164140 | Other | CLIA IDENTIFIER | |
| CB0P565510 | Other | BLUE CROSS BLUE SHIELD LEGACY NUMBER | |
| CJ2100 | Other | RAILROAD MEDICARE GROUP LEGACY NUMBER | |
| 109052400 | Other | GOVERNMENT WORKERS COMP | |
| 5934707 | Other | AETNA LEGACY NUMBER | |
| P821809B | Other | OXFORD HEALTHCARE LEGACY NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65 004988 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ian S Goldbaum DPM PA | Podiatrist | Current | Accepting new patients |
Locations
16244 S Military Trl
Ste 290
Delray Beach, FL 33484
Phone (561) 499-0033
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1710926340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 NORTH RD STE 304",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126011173",
"telephone_number": "845-471-9410",
"fax_number": "845-471-7372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 FAIRMONT AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032422",
"telephone_number": "845-454-0630",
"fax_number": "845-454-0637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROMLEY",
"first_name": "CHRISTOPHER",
"middle_name": "KENT",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "65 004988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS EMPIRE PLAN UNITED HEALTHCARE LEGACY NUMBER",
"identifier": "1793752",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS LEGACY NUMBER",
"identifier": "1C8554",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY LEGACY NUMBER",
"identifier": "000405793008",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01515315",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP LEGACY NUMBER",
"identifier": "10032229",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH PLAN GROUP LEGACY NUMBER",
"identifier": "200053170",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO SELECT LEGACY NUMBER",
"identifier": "39099",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH PLAN LEGACY NUMBER",
"identifier": "953501",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY GROUP LEGACY NUMBER",
"identifier": "408871001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US LEGACY NUMBER",
"identifier": "505870",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI LEGACY NUMBER",
"identifier": "6200857",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE LEGACY NUMBER",
"identifier": "139099",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LAST 5 TIN",
"identifier": "30061",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURE HORIZONS LEGACY NUMBER",
"identifier": "P82109",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH CARE LEGACY NUMBER",
"identifier": "P821809B",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE LEGACY NUMBER",
"identifier": "100107789201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PRACTICE NPI",
"identifier": "1235164997",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE GROUP LEGACY NUMBER",
"identifier": "1793752",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTHCARE GROUP LEGACY NUMBER",
"identifier": "200053170",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA IDENTIFIER",
"identifier": "33D0164140",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD LEGACY NUMBER",
"identifier": "CB0P565510",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP LEGACY NUMBER",
"identifier": "CJ2100",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GOVERNMENT WORKERS COMP",
"identifier": "109052400",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA LEGACY NUMBER",
"identifier": "5934707",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTHCARE LEGACY NUMBER",
"identifier": "P821809B",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.