Organization Active NPI

Stabile Podiatry PC

  • Foot & Ankle Surgery Podiatrist
  • Deer Park, NY
National Provider Identifier
1881966349
Registry record updated Mar 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
006242 Issued in NY
Legal business name
STABILE PODIATRY PC
Practice address
336 Commack Rd
Unit 10
Deer Park, NY 11729-5518
Phone
(516) 606-6740
NPI assigned
Jan 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2012

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

Authorized official

Name
Dr. Robert Joseph Stabile, DPMNPI 1023205341
Title
Owner
Phone
(516) 606-6740

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 PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 006242 NY Primary

Addresses

Primary practice location

336 Commack Rd
Unit 10
Deer Park, NY 11729-5518

Mailing address

336 Commack Rd
Unit 10
Deer Park, NY 11729-5518
Phone (516) 606-6740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000512 NY Part B Supplier - Clinic/Group Practice 6709047442 Receives reassigned benefits from 2 practitioners
Practice locations: West Babylon, NY

National Provider Directory

National Provider Directory

Locations

290 S Wellwood Ave
Lindenhurst, NY 11757
Phone (631) 225-2999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331424000000",
    "number": "1881966349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 COMMACK RD",
            "address_2": "UNIT 10",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295518",
            "telephone_number": "516-606-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 COMMACK RD",
            "address_2": "UNIT 10",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295518",
            "telephone_number": "516-606-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STABILE PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-03-11",
        "status": "A",
        "authorized_official_last_name": "STABILE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-606-6740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.