Active NPI
Elise C. Richtol, DPM
- Podiatrist
- Waterford, NY
National Provider Identifier
1740260298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N004804
- Practice address
- 3 Partridge LN
Waterford, NY 12188-1091 - Phone
- (518) 233-1188
- Fax
- (518) 233-1188
- NPI assigned
- Jan 20, 2006
- Sex
- Female
- 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 | N004804 | NY | Primary |
Addresses
Primary practice location
3 Partridge LN
Waterford, NY 12188-1091
Mailing address
3 Partridge LN
Waterford, NY 12188-1091
Phone (518) 233-1188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01722590 | Medicaid | NY |
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2014 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N004804 | NY | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222905600000",
"number": "1740260298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 PARTRIDGE LN",
"city": "WATERFORD",
"state": "NY",
"postal_code": "121881091",
"telephone_number": "518-233-1188",
"fax_number": "518-233-1188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 PARTRIDGE LN",
"city": "WATERFORD",
"state": "NY",
"postal_code": "121881091",
"telephone_number": "518-233-1188",
"fax_number": "518-233-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHTOL",
"first_name": "ELISE",
"middle_name": "C.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-20",
"last_updated": "2008-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N004804",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01722590",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.