NPIMap

Organization Active NPI

Country Foot Care Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Mineola, NY
National Provider Identifier
1831562396
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
COUNTRY FOOT CARE PODIATRY PLLC
Practice address
155 Mineola Blvd
Suite B
Mineola, NY 11501-3920
Phone
(516) 741-3338
Fax
(516) 741-4601
NPI assigned
Nov 5, 2015
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Steven Brook, DPM
Title
Owner
Phone
(516) 741-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

155 Mineola Blvd
Suite B
Mineola, NY 11501-3920

Mailing address

155 Mineola Blvd
Suite B
Mineola, NY 11501-3920
Phone (516) 741-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160126000057 NY Part B Supplier - Clinic/Group Practice 1254634223 Receives reassigned benefits from 9 practitioners
Practice locations: Mineola, NY; Williston Park, NY; East Patchogue, NY
O20160521000127 NY DME Supplier - Physician - Podiatry 1254634223 Practice locations: Mineola, NY

National Provider Directory

National Provider Directory
Tax ID family
Country Foot Care Podiatry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2110 Northern Blvd
Ste 208
Manhasset, NY 11030
Phone (516) 627-5113

7001 Grand Ave
Maspeth, NY 11378
Phone (718) 639-0499

155 Mineola Blvd
Ste B
Mineola, NY 11501
Phone (516) 741-3338

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1831562396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MINEOLA BLVD",
            "address_2": "SUITE B",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013920",
            "telephone_number": "516-741-3338",
            "fax_number": "516-741-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MINEOLA BLVD",
            "address_2": "SUITE B",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013920",
            "telephone_number": "516-741-3338",
            "fax_number": "516-741-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY FOOT CARE PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "BROOK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-741-3338",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.