Individual provider Active NPI

Anthony C Innamorato, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Bay Shore, NY
National Provider Identifier
1851380778
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
N005823-1 Issued in NY
Practice address
1555 Sunrise Hwy
Suite 5
Bay Shore, NY 11706-6027
Phone
(631) 328-1931
Fax
(631) 328-1930
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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 N005823-1 NY Primary

Addresses

Primary practice location

1555 Sunrise Hwy
Suite 5
Bay Shore, NY 11706-6027

Mailing address

323 Linton Ave
Lindenhurst, NY 11757-6337
Phone (631) 553-4785

Other identifiers 1

IdentifierTypeStateIssuer
02280500MedicaidNY

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
I20040405000552 NY Practitioner - Podiatry 9133112485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1555 Sunrise Hwy
Suite 5
Bay Shore, NY 11706-6027
Phone (631) 328-1931

Merit-based Incentive Payment System (MIPS)

Final score
76.78 of 100Reported as individual
Quality
44.35
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue29
Removal of nail tissue760
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005823-1NYMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aci Podiatry, PC Primary Podiatric Medicine CurrentSince Jul 24, 2008 Accepting new patients
Suffolk Podiatry PC Past Accepting new patients

Locations

1555 Sunrise Hwy
Ste 5
Bay Shore, NY 11706
Phone (631) 328-1931

16411 Chapin Pkwy
Jamaica, NY 11432
Phone (718) 296-7800

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1851380778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 LINTON AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117576337",
            "telephone_number": "631-553-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SUNRISE HWY",
            "address_2": "SUITE 5",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066027",
            "telephone_number": "631-328-1931",
            "fax_number": "631-328-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNAMORATO",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N005823-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02280500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.