NPIMap

Organization Active NPI

Podiatry Services of Central New York P C

  • Foot & Ankle Surgery Podiatrist
  • North Syracuse, NY
National Provider Identifier
1851435770
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
002777 Issued in NY
Legal business name
PODIATRY SERVICES OF CENTRAL NEW YORK P C
Practice address
514 S Bay Rd
North Syracuse, NY 13212-3627
Phone
(315) 458-1777
NPI assigned
Feb 16, 2007
Last updated
Mar 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Authorized official

Name
Dr. Freddie L. Edelman, DPMNPI 1508843855
Title
Owner
Phone
(315) 458-1777

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 & Ankle Surgery Podiatrist 213ES0103X 002777 NY Primary

Addresses

Primary practice location

514 S Bay Rd
North Syracuse, NY 13212-3627

Mailing address

514 S Bay Rd
North Syracuse, NY 13212-3627
Phone (315) 458-1777

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050324000891 NY Part B Supplier - Clinic/Group Practice 2062468895 Receives reassigned benefits from 11 practitioners
Practice locations: Syracuse, NY; Pulaski, NY; Oswego, NY; Norwich, NY; Chittenango, NY; North Syracuse, NY; Cortland, NY; East Syracuse, NY…
O20100930029647 NY DME Supplier - Physician - PodiatryDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Orthotic Personnel 2062468895 Practice locations: North Syracuse, NY

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Podiatry Services of C13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

514 S Bay Rd
Syracuse, NY 13212
Phone (315) 458-1777

Practitioners & affiliated clinicians

Practitioners 11

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1851435770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S BAY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123627",
            "telephone_number": "315-458-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S BAY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123627",
            "telephone_number": "315-458-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY SERVICES OF CENTRAL NEW YORK P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "EDELMAN",
        "authorized_official_first_name": "FREDDIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-458-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "002777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.