Individual provider Active NPI

Jay Arthur Comassar, DPM

  • Podiatrist
  • Lindenhurst, NY
National Provider Identifier
1790772663
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003308 Issued in NY
Practice address
656 No. Wellwood Ave.
Ste. 208B
Lindenhurst, NY 11757
Phone
(631) 957-7277
Fax
(631) 226-0900
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N3308 NY
Podiatrist 213E00000X N003308 NY Primary

Addresses

Primary practice location

656 No. Wellwood Ave.
Ste. 208B
Lindenhurst, NY 11757

Mailing address

656 No. Wellwood Ave.
Ste. 208B
Lindenhurst, NY 11757
Phone (631) 957-7277

Other identifiers 1

IdentifierTypeStateIssuer
007866635MedicaidNY

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

LicenseStateTypeSpecialty
N003308NYMDPodiatrist
N3308NYMDPodiatrist
003308NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790772663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 NO. WELLWOOD AVE.",
            "address_2": "STE. 208B",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-957-7277",
            "fax_number": "631-226-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 NO. WELLWOOD AVE.",
            "address_2": "STE. 208B",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-957-7277",
            "fax_number": "631-226-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMASSAR",
        "first_name": "JAY",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N3308",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007866635",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.