East Patchogue Podiatry P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

EAST PATCHOGUE PODIATRY P.C.

Practice address

285 Sills Rd
BLDG 5-6 #H
East Patchogue, NY 11772-4869

Phone

(631) 654-5566

NPI assigned

Dec 3, 2007

Last updated

Feb 27, 2020By 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

Mr. Edward James Kormylo, DPMNPI 1568436392

Title

Owner

Phone

(631) 654-5566

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• East Patchogue Podiatry P.C.

  • Podiatric Clinic/Center
  • Commack, NY
  • NPI 1659848802
  NPPES parent name

Practitioners 7

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.

• Kristina Adriana Karlic, DPM

  • Foot & Ankle Surgery Podiatrist
  • East Patchogue, NY
  • NPI 1316191398
  Medicare reassignment Care Compare group NPD
• Edward C Kormylo, DPM

  • Foot & Ankle Surgery Podiatrist
  • East Patchogue, NY
  • NPI 1134373467
  Medicare reassignment Care Compare group NPD
• Edward J Kormylo, DPM

  • Foot Surgery Podiatrist
  • Patchogue, NY
  • NPI 1568436392
  Medicare reassignment NPD Authorized official
• Sandra Zawadka, DPM

  • Foot Surgery Podiatrist
  • Manhasset, NY
  • NPI 1164050704
  Medicare reassignment Care Compare group NPD
• Joseph Michael Zehentner, DPM

  • Podiatrist
  • East Patchogue, NY
  • NPI 1588227524
  Medicare reassignment Care Compare group NPD
• Vincent Francis Gallo Jr., DPM

  • Foot & Ankle Surgery Podiatrist
  • Newburgh, NY
  • NPI 1144803883
  Medicare reassignment NPD
• Sara El Bashir, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wayne, NJ
  • NPI 1396189585

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1871775726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 5-6 #H",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-654-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 5-6 #H",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-654-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PATCHOGUE PODIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "KORMYLO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-654-5566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00588743",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.