Active NPI
Samuel B Pearlstein, DPM
- Podiatrist
- Fayetteville, NY
National Provider Identifier
1740387703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- N003595-1
- Practice address
- 512 Towne Dr
Fayetteville, NY 13066-1331 - Phone
- (315) 637-5500
- Fax
- (315) 637-5588
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- 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 | N003595-1 | NY | Primary |
Addresses
Primary practice location
512 Towne Dr
Fayetteville, NY 13066-1331
Mailing address
512 Towne Dr
Fayetteville, NY 13066-1331
Phone (315) 637-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N003595-1 | NY | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740387703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 TOWNE DR",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130661331",
"telephone_number": "315-637-5500",
"fax_number": "315-637-5588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 TOWNE DR",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130661331",
"telephone_number": "315-637-5500",
"fax_number": "315-637-5588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARLSTEIN",
"first_name": "SAMUEL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N003595-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.