JB Podiatric Medicine and Surgery PC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

N006041 Issued in NY

Legal business name

JB PODIATRIC MEDICINE AND SURGERY PC

Practice address

1130 Brighton Beach Ave Apt 1CC
Brooklyn, NY 11235-5515

Phone

(718) 648-2707

Fax

(347) 462-2908

NPI assigned

Apr 20, 2007

Last updated

May 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Julia Bondarenko, DPMNPI 1467560276

Title

President

Phone

(917) 699-4139

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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.

• Julia Bondarenko, DPM

  • Foot Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1467560276
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1851518658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CHESTER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125710",
            "telephone_number": "917-699-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BRIGHTON BEACH AVE APT 1CC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355515",
            "telephone_number": "718-648-2707",
            "fax_number": "347-462-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JB PODIATRIC MEDICINE AND SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "BONDARENKO",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-699-4139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N006041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02841734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Foot Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.