NPIMap

Organization Active NPI

Suffolk County Foot Care PLLC

  • Podiatrist
  • Kings Park, NY
National Provider Identifier
1770754020
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SUFFOLK COUNTY FOOT CARE PLLC
Practice address
63 Main St
Kings Park, NY 11754-2706
Phone
(631) 269-4600
Fax
(631) 269-0801
NPI assigned
Mar 14, 2008
Last updated
Feb 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Dr. Stephen Bradley Ravitz, DPMNPI 1407933484
Title
DPM
Phone
(631) 269-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

63 Main St
Kings Park, NY 11754-2706

Mailing address

63 Main St
Kings Park, NY 11754-2706
Phone (631) 269-4600

National Provider Directory

National Provider Directory

Locations

63 Main St
Kings Park, NY 11754
Phone (631) 269-4600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1770754020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542706",
            "telephone_number": "631-269-4600",
            "fax_number": "631-269-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542706",
            "telephone_number": "631-269-4600",
            "fax_number": "631-269-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK COUNTY FOOT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "RAVITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "631-269-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.