NPIMap

Organization Active NPI

Westside Podiatry Group LLC

  • Foot Surgery Podiatrist
  • Rochester, NY
National Provider Identifier
1730623869
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
WESTSIDE PODIATRY GROUP LLC
Doing business as
Westside podiatry group
Practice address
507 Beahan Rd
Rochester, NY 14624-3403
Phone
(585) 225-2290
Fax
(585) 247-3614
NPI assigned
Dec 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Dr. Daniel Eric Tellem, DPMNPI 1588714042
Title
Podiatrist
Phone
(585) 247-2170

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 Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X NY Primary

Addresses

Primary practice location

507 Beahan Rd
Rochester, NY 14624-3403

Mailing address

507 Beahan Rd
Rochester, NY 14624-3403
Phone (585) 247-2170

Other identifiers 1

IdentifierTypeStateIssuer
04203316MedicaidNY

Other names 1

  • Westside podiatry group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170524002625 NY DME Supplier - Physician - Podiatry 3971543554 Practice locations: Rochester, NY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Westside Podiatry Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

507 Beahan Rd
Rochester, NY 14624
Phone (585) 247-2170

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": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1730623869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-247-2170",
            "fax_number": "585-247-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-225-2290",
            "fax_number": "585-247-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PODIATRY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "TELLEM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "585-247-2170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04203316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside podiatry group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westside podiatry group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.