Organization Active NPI

Discover Podiatry, P.C.

  • Foot Surgery Podiatrist
  • Bay Shore, NY
National Provider Identifier
1790965713
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
005107 Issued in NY
Legal business name
DISCOVER PODIATRY, P.C.
Practice address
2111 Union Blvd
Bay Shore, NY 11706-8017
Phone
(631) 206-3106
Fax
(631) 206-3108
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dana Barry Siegel, D.P.M.NPI 1821099904
Title
Owner/Ceo
Phone
(631) 206-3106

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
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 005107 NY Primary

Addresses

Primary practice location

2111 Union Blvd
Bay Shore, NY 11706-8017

Mailing address

21 Stacey LN
Smithtown, NY 11787-2354
Phone (631) 206-3106

Other identifiers 1

IdentifierTypeStateIssuer
01688884MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000084 NY Part B Supplier - Clinic/Group Practice 0244134658 Receives reassigned benefits from 1 practitioner
Practice locations: Bay Shore, NY; Islip, NY

National Provider Directory

National Provider Directory

Locations

2111 Union Blvd
Bay Shore, NY 11706
Phone (631) 206-3106

215 Islip Ave
Ste 2
Islip, NY 11751
Phone (631) 277-4060

Practitioners & affiliated clinicians

Practitioners 2

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": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1790965713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 STACEY LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872354",
            "telephone_number": "631-206-3106",
            "fax_number": "631-206-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068017",
            "telephone_number": "631-206-3106",
            "fax_number": "631-206-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVER PODIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "BARRY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "631-206-3106",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "005107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01688884",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.