NPIMap

Organization Active NPI

Innovative Footcare

  • Podiatrist
  • Hauppauge, NY
National Provider Identifier
1891816278
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N003762 Issued in NY
Legal business name
INNOVATIVE FOOTCARE
Practice address
111 Smithtown Byp Ste 103
Hauppauge, NY 11788-2512
Phone
(631) 724-3338
Fax
(631) 724-2860
NPI assigned
Apr 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Matthew Locastro, DPMNPI 1982606323
Title
Doctor
Phone
(718) 292-7081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N003762 NY Primary
Podiatrist 213E00000X N004738 NY
Podiatrist 213E00000X N005916 NY

Addresses

Primary practice location

111 Smithtown Byp Ste 103
Hauppauge, NY 11788-2512

Mailing address

391 E 149TH St
Bronx, NY 10455-3907
Phone (718) 292-7081

Other identifiers 1

IdentifierTypeStateIssuer
00873914MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891816278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553907",
            "telephone_number": "718-292-7081",
            "fax_number": "718-292-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SMITHTOWN BYP STE 103",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882512",
            "telephone_number": "631-724-3338",
            "fax_number": "631-724-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE FOOTCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCASTRO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-292-7081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N003762",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004738",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005916",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00873914",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.