NPIMap

Organization Active NPI

Preferred Family Footcare, LLP

  • Podiatrist
  • Flushing, NY
National Provider Identifier
1740315308
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PREFERRED FAMILY FOOTCARE, LLP
Practice address
14149 73Rd Ave
Flushing, NY 11367-2340
Phone
(718) 544-7575
Fax
(718) 544-7132
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Dr. Jonathan Michael Klein, DPMNPI 1851327761
Title
Partner
Phone
(718) 544-7575

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 MULTIPLE SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

14149 73Rd Ave
Flushing, NY 11367-2340

Mailing address

14149 73Rd Ave
Flushing, NY 11367-2340
Phone (718) 544-7575

Other identifiers 5

IdentifierTypeStateIssuer
01779299MedicaidNY
CN8646OtherNYRAILROAD MEDICARE
01779340MedicaidNY
P875616OtherOXFORD
P875620OtherNYOXFORD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930056939 NY DME Supplier - Physician - Podiatry 7810039401 Practice locations: Flushing, NY
O20110401000082 NY Part B Supplier - Clinic/Group Practice 7810039401 Receives reassigned benefits from 5 practitioners
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory

Locations

24916 Grand Central Pkwy
Bellerose, NY 11426
Phone (718) 279-9404

14149 73rd Ave
Kew Gardens Hills, NY 11367
Phone (718) 544-7575

Practitioners & affiliated clinicians

Practitioners 5

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1740315308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14149 73RD AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672340",
            "telephone_number": "718-544-7575",
            "fax_number": "718-544-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14149 73RD AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672340",
            "telephone_number": "718-544-7575",
            "fax_number": "718-544-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED FAMILY FOOTCARE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-544-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01779299",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN8646",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01779340",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P875616",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P875620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.