Organization Active NPI

Footcare Podiatry PC

  • Specialist
  • New York, NY
National Provider Identifier
1881766137
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
N005097 Issued in NY
Legal business name
FOOTCARE PODIATRY PC
Practice address
309 E 104TH St
New York, NY 10029-5514
Phone
(212) 289-3388
NPI assigned
Nov 14, 2006
Last updated
Dec 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Stephen J Bennett, D.P.M.NPI 1467524702
Title
Sole Proprietor
Phone
(212) 289-3388

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X N005097 NY Primary

Addresses

Primary practice location

309 E 104TH St
New York, NY 10029-5514

Mailing address

309 E 104TH St
New York, NY 10029-5514

Other identifiers 1

IdentifierTypeStateIssuer
01814768MedicaidNY

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930023242 NY DME Supplier - Physician - Podiatry 3678780681 Practice locations: New York, NY
O20101214000670 NY Part B Supplier - Clinic/Group Practice 3678780681 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1881766137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 104TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 104TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295514",
            "telephone_number": "212-289-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTCARE PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "212-289-3388",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "N005097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01814768",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.