Organization Active NPI

Footprint Podiatry Care PC

  • Podiatrist
  • Forest Hills, NY
National Provider Identifier
1750802963
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOTPRINT PODIATRY CARE PC
Practice address
10828 68TH Dr
Forest Hills, NY 11375-2951
Phone
(718) 520-0028
NPI assigned
Jun 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Dolma MagarNPI 1639591233
Title
DPM
Phone
(646) 591-7594

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 SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

10828 68TH Dr
Forest Hills, NY 11375-2951

Mailing address

7261 113TH St Apt 2R
Forest Hills, NY 11375-5601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211210002357 NY Part B Supplier - Clinic/Group Practice 3476943119 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1750802963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 113TH ST APT 2R",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10828 68TH DR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752951",
            "telephone_number": "718-520-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINT PODIATRY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "MAGAR",
        "authorized_official_first_name": "DOLMA",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "646-591-7594"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.