Active NPI
Family Footcare and Surgery PLLC
- Foot Surgery Podiatrist
- Highland Mills, NY
National Provider Identifier
1780834051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- N006232
- Legal business name
- FAMILY FOOTCARE AND SURGERY PLLC
- Practice address
- 29 Heather RDG
Highland Mills, NY 10930-8321 - Phone
- (718) 793-5511
- Fax
- (718) 793-5512
- NPI assigned
- Sep 23, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tetyana Boreesenko, DPM
- Title
- Owner
- Phone
- (718) 793-5511
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | N006232 | NY | Primary |
| Podiatric Clinic/Center | 261QP1100X |
Addresses
Primary practice location
29 Heather RDG
Highland Mills, NY 10930-8321
Mailing address
29 Heather RDG
Highland Mills, NY 10930-8321
Phone (718) 793-5511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
10721 Queens Blvd
Ste 11
Forest Hills, NY 11375
Phone (718) 377-7629
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Highland Mills, NY
- NPI 1649448879
-
- Podiatrist
- Forest Hills, NY
- NPI 1265439905
-
- Hematology & Oncology Physician
- Brooklyn, NY
- NPI 1629061155
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710806400000",
"number": "1780834051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 HEATHER RDG",
"city": "HIGHLAND MILLS",
"state": "NY",
"postal_code": "109308321",
"telephone_number": "718-793-5511",
"fax_number": "718-793-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 HEATHER RDG",
"city": "HIGHLAND MILLS",
"state": "NY",
"postal_code": "109308321",
"telephone_number": "718-793-5511",
"fax_number": "718-793-5512"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY FOOTCARE AND SURGERY PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-23",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A",
"authorized_official_last_name": "BOREESENKO",
"authorized_official_first_name": "TETYANA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "718-793-5511",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot Surgery",
"state": "NY",
"license": "N006232",
"primary": true
},
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Highland Mills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.