Southern Tier Podiatry PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

SOUTHERN TIER PODIATRY PLLC

Practice address

4104 Old Vestal Rd
Suite 104
Vestal, NY 13850-3500

Phone

(607) 217-5668

Fax

(607) 821-0255

NPI assigned

Feb 14, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Marilyn S Boyuka, D.P.MNPI 1447286638

Title

Owner

Phone

(607) 217-5668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11190/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marilyn S Boyuka, DPM

  • Foot & Ankle Surgery Podiatrist
  • Vestal, NY
  • NPI 1447286638

  Foot & Ankle Surgery, NY

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1831439660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 OLD VESTAL RD",
            "address_2": "SUITE 104",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503500",
            "telephone_number": "607-217-5668",
            "fax_number": "607-821-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 OLD VESTAL RD",
            "address_2": "SUITE 104",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503500",
            "telephone_number": "607-217-5668",
            "fax_number": "607-821-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "BOYUKA",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-217-5668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dallin Sorensen, DPM
• Charles Michael Sostowski, DDS
• Southern New York Neurosurgical Group
• Southern Tier Hearing Services PLLC
• Southern Tier Pain Management
• Southern Tier Psychiatry PLLC
• Southern Tier Women'S Health Services LLC
• Eileen Elizabeth Spencer
• Patricia E Spencer, NP-C
• David E Sperber, MD

• All providers in Vestal, NY
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.