Individual provider Active NPI

Michael Allen Masias, D.P.M.

  • Podiatrist
  • Rensselaer, NY
National Provider Identifier
1740342633
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N004777 Issued in NY
Practice address
34 Broadway
Rensselaer, NY 12144-2916
Phone
(845) 210-3597
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X N004777 NY
Sports Medicine Podiatrist 213ES0000X N004777 NY
Foot Surgery Podiatrist 213ES0131X N004777 NY
Podiatrist 213E00000X N004777 NY Primary

Addresses

Primary practice location

34 Broadway
Rensselaer, NY 12144-2916

Mailing address

PO Box 162
Rensselaer, NY 12144-0162
Phone (518) 320-8659

Other identifiers 1

IdentifierTypeStateIssuer
011963549MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070605000146 NY Practitioner - Podiatry 5991803645 Practice locations: Rensselaer, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Broadway
Rensselaer, NY 12144-2916

34 Broadway
Rensselaer, NY 12144-2916
Phone (518) 320-8659

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004777NYMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1740342633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121440162",
            "telephone_number": "518-320-8659",
            "fax_number": "888-382-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BROADWAY",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121442916",
            "telephone_number": "845-210-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIAS",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N004777",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "NY",
            "license": "N004777",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N004777",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011963549",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.