NPIMap

Organization Active NPI

Healthdrive Podiatry Group, PC

  • Podiatrist
  • Middletown, CT
National Provider Identifier
1770514101
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
HEALTHDRIVE PODIATRY GROUP, PC
Practice address
101 Centerpoint Dr Ste 215
Middletown, CT 06457-7568
Phone
(888) 964-6681
Fax
(888) 662-0859
NPI assigned
Jul 5, 2006
Organization subpart
Yes
Parent organization
HEALTHDRIVE PODIATRY GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Authorized official

Name
Dr. Riya Altomonte, DPM
Title
President/Practice Director
Phone
(857) 255-0486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

101 Centerpoint Dr Ste 215
Middletown, CT 06457-7568

Mailing address

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

Other identifiers 3

IdentifierTypeStateIssuer
004124682MedicaidCT
CA5925OtherCTMEDICARE RAILROAD
50HEALTHPODCT01OtherCTBLUE CROSS BLUE SHIELD

Other names 1

  • HealthDrive Podiatry Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000371 CT Part B Supplier - Clinic/Group Practice 3375446958 Receives reassigned benefits from 10 practitioners
Practice locations: Middletown, CT

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Healthdrive Podiatry GRP PC10 organizations share this tax ID, including this one
Part of
Healthdrive Podiatry GRP PC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

438 Main St
Ste 204
Middletown, CT 06457

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Morristown ManorMorristown, IN, CCN 155691 Skilled nursing facility Adp of the SNF Mar 7, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 10

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1770514101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CENTERPOINT DR STE 215",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577568",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHDRIVE PODIATRY GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTHDRIVE PODIATRY GROUP, PC",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "ALTOMONTE",
        "authorized_official_first_name": "RIYA",
        "authorized_official_title_or_position": "PRESIDENT/PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "857-255-0486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004124682",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA5925",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50HEALTHPODCT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.