Individual provider Active NPI

Edgard Nau, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • New York, NY
National Provider Identifier
1801899828
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
N004265 Issued in NY
Practice address
4915 Broadway
Suite 5B
New York, NY 10034-3125
Phone
(212) 569-0269
Fax
(212) 658-9928
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X N004265 NY Primary

Addresses

Primary practice location

4915 Broadway
Suite 5B
New York, NY 10034-3125

Mailing address

4915 Broadway
Suite 5B
New York, NY 10034-3125
Phone (212) 569-0269

Other identifiers 1

IdentifierTypeStateIssuer
01371402MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100727000824 NY Practitioner - Podiatry 8123151206 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N004265NYMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1801899828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "address_2": "SUITE 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343125",
            "telephone_number": "212-569-0269",
            "fax_number": "212-658-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 BROADWAY",
            "address_2": "SUITE 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100343125",
            "telephone_number": "212-569-0269",
            "fax_number": "212-658-9928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAU",
        "first_name": "EDGARD",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N004265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01371402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.